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Physiological parameter monitoring is essential to medical staff to evaluate, diagnose and treat patients in neonatal intensive care unit (NICU). Monitoring in NICU includes basic vital signal monitoring and functional monitoring. Basic vital signal monitoring (including ECG, respiration, SpO2, blood pressure, temperature) is advanced and focus on study of usability, continuity and anti-interference. Functional monitoring (including respiratory function, circulatory function, cerebral function) still focus on study of monitoring precision and reliability. Meanwhile, video monitoring and artifact intelligence have presented well performance on improving monitoring precision and anti-interference. In this article, the main parameters and relevant measurement technology for monitoring critical neonates were described.
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Humans , Infant, Newborn , Intensive Care Units, Neonatal , Monitoring, Physiologic , Reproducibility of Results , Respiration , Technology , Vital SignsABSTRACT
Objective To investigate the value of S100β protein and electroencephalogram ( EEG) in cerebral function monitoring of critically ill children. Methods Sixty critically ill children admitted in our department from September 2014 to December 2016,were divided into 2 groups according to pediatric critical illness score ( PCIS) ,30 cases in critical group ( PCIS≤80 scores) and 30 cases of non critical group ( PCIS>80 scores) . Serum samples were collected from the 60 cases at 24 h,72 h and 1 week after admission, respectively. The serum S100β protein and EEG were dynamically monitored on 3 time points. ELISA was used to test the content of S100βprotein of collected samples. Results There was no statistically significant difference in gender and age between critical group and non critical group[ male/female:22/8 vs. 21/9;age:(3. 68 ± 1. 37)years vs. (2. 52 ± 0. 86)years,P>0. 05]. The glasgow score of critical group was lower than that of non critical group(8. 67 ± 1. 83 vs. 13. 05 ± 2. 94,P<0. 05). Serum S100βprotein contents of critical group were(112. 55 ± 29. 20)μg/L,(120. 86 ± 17. 10)μg/L,and (279. 82 ± 28. 80)μg/L) at 24 h,72 h and 1 week respectively, which were obviously higher than those of non cricical group [ ( 0. 51 ± 0. 06 )μg/L, (0. 32 ± 0. 03)μg/L,(0. 34 ± 0. 05)μg/L](P<0. 05). Meanwhile,the abnormal rate of EEG monitoring of critical group were 19 cases ( 63. 3％) , 18 cases ( 60. 0％) , 20 cases ( 66. 7％) at 24 hours, 72 hours and 1 week respectively,which were also obviously higher than those of non critical group [ 9 cases ( 30. 0％) , 7 cases(23. 3％),6 cases(20. 0％)](P<0. 05). Conclusion Both serum S100β protein and dynamically EEG monitoring contribute to detect the status of cerebral injury in early stage, with significant value in cerebral function monitoring of critically ill children.
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Objective To explore the effect of intrauterine growth restriction (IUGR) on the development of brain function in premature infants. Methods A total of 110 premature infants of gestation age of 32-36 weeks were monitored by NicoletOne neonatal cerebral function monitor within 72 hours after birth during January 2015 to February 2016. There were 50 small for gestational age infants (SGA) and 60 appropriate for gestational age infants (AGA). They were continuously monitored for 4-6 hours every time, and the indices of aEEG continuity, sleep wake cycle (SWC), inter-burst interval (IBI), minimum and maximum voltage were compared between two groups. Results The frequency of aEEG continuity, the rate of SWC, and the maximum and minimum voltage in SGA group were all lower than those in AGA group, while the IBI was longer than that in AGA group, and there were significant differences (P 0.05) among birth weight
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Objective To explore the changes of amplitude integrated electroencephalogram (aEEG) during brain development in premature.Methods One hundred and forty-eight premature (gestational age 28-36 weeks) were selected.According to their gestational ages,148 premature were divided into 28-30 weeks group(40 cases),with 21 male,19 female;＞30-33 weeks group (49 cases),with 25 male,24 female;＞33-36 weeks group (59 cases),33 male,26 female.At the same time,40 cases of gestational age 37-40 weeks full-term newborns were selected as control group,with 23 male,17 female.Olympic CFM 6000 cerebral function monitor(produced by the American Natus company) was used to detect the changes of their aEEG,and analysis of the changes of aEEG were conducted.The first monitor was performed 3 days after birth,then once a week,monitoring for 2 hours each time,till the premature were discharged from hospital.The average of the monitoring data was obtained as a result for the analysis,and data analysis was conducted by using SAS 9.0 statistical software.Results The sleep-wake cycle continuity voltage positive rate and cycle occurrence rate of the 28-30 weeks,＞ 30-33 weeks,＞ 33-36 weeks premature were significantly lower than those of the 37-40 weeks full-term newborns (all P ＜ 0.05).The 28-30 weeks,＞ 30-33 weeks,＞ 33-36 weeks premature spectrun lower bound voltage value of quiet sleep cycle and activity sleep cycle were significantly lower than those of the 37-40 weeks full-term newborns (all P ＜ 0.05).The 28-30 weeks,＞ 30-33 weeks,＞ 33-36 weeks premature spectrum width of quiet sleep cycle and activity sleep cycle were significantly wider than the 37-40 weeks full-term newborns (F =13.444,11.982,all P ＜ 0.05).The 28-30 weeks,＞ 30-33 weeks,＞ 33-36 weeks premature total duration of sleep cycle were significantly higher than the 37-40 weeks full-term newborns (F =12.451,P ＜ 0.05).Conclusions With the increase of gestational age,premature brain development becomes gradually mature,and aEEG can reflect the degree of premature brain development to some extent.
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Objective To develop a portable cerebral function physical therapy apparatus to heal the brain disorder due to oxygen deficit such as lapsus memoriae,insomnia,headache and etc.Methods The apparatus integrated transcranial microcurrent stimulation technique and unified wearing,which was composed of an analog brain wave signal generator,a protective goggles against ultraviolet with a stimulus electrode embedded in the mounting and a belt with a leather cup fixing the generator.The generator used the master control chip to regulate the constant current generating circuit to produce bipolar constant microcurrent for the training of transcranial microcurrent stimulation.Results The effectiveness rate by the apparatus was 75％ for headache and insomnia in plateau conditions,with daily operation non affected.conclusion The apparatus behaves well in convenience,portability and non invasion,and can effectively relieve headache and insomnia in plateau conditions.
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Objective To develop a portable cerebral function physical therapy apparatus to heal the brain disorder due to oxygen deficit such as lapsus memoriae,insomnia,headache and etc.Methods The apparatus integrated transcranial microcurrent stimulation technique and unified wearing,which was composed of an analog brain wave signal generator,a protective goggles against ultraviolet with a stimulus electrode embedded in the mounting and a belt with a leather cup fixing the generator.The generator used the master control chip to regulate the constant current generating circuit to produce bipolar constant microcurrent for the training of transcranial microcurrent stimulation.Results The effectiveness rate by the apparatus was 75％ for headache and insomnia in plateau conditions,with daily operation non affected.conclusion The apparatus behaves well in convenience,portability and non invasion,and can effectively relieve headache and insomnia in plateau conditions.
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@#Objective To establish a coupled model combining the rat brain nuclei microelectrode recordings and the behavioristics for rehabilitation experiment. Methods The modified indwelling tube connection fixed device was put inside the rats' back, and the microprobes were implanted into related neural nucleus. A signal connection was made between self-administration system and electrophysiological data acquisition system. The rat was addicted after training by self-administration system. The related cerebral nucleus electrophysiological sig-nals were recorded in different states of addiction. Results and Conclusion The modified indwelling tube connection fixed device has a bet-ter quality for reducing the phenomenon of leak. The signal was well in the combination of two different systems. The signals for the rat's ac-tion and neural electrical were recorded in the same time.
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Objective To investigate the effect of unilateral electric stimulation of lower limbs movement on central nervous system. Methods 8 right-footed healthy men accepted electrical stimulation to evoke dorsiflexion of the right ankle, while the cerebral cortex activa-tions were observed with functional magnetic resonance imaging. Results For electrical stimulation evoked contraction task, the significant activations were observed in the bilateral primary motor cortex, primary sensory area, secondary somatosensory cortex, cingulated gyrus;ip-silateral premotor area and contralateral supplementary motor area. Conclusion Unilateral electrical stimulation may result in activations of bilateral cerebral cortex.
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@#Objective To investigate the effect of unilateral electric stimulation of lower limbs movement on central nervous system. Methods 8 right-footed healthy men accepted electrical stimulation to evoke dorsiflexion of the right ankle, while the cerebral cortex activations were observed with functional magnetic resonance imaging. Results For electrical stimulation evoked contraction task, the significant activations were observed in the bilateral primary motor cortex, primary sensory area, secondary somatosensory cortex, cingulated gyrus; ipsilateral premotor area and contralateral supplementary motor area. Conclusion Unilateral electrical stimulation may result in activations of bilateral cerebral cortex.
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Objective To compare the scores of amplitude-integrated electroencephalogram (aEEG) tracings between preterm infants who were smaller for gestational age (SGA) and those who were appropriate for gestation (AGA).Methods A total of 139 preterm infants were collected in the Neonatal Intensive Care Unit of the Affiliated Hospital of Guangdong Medical College during the period of Mar.2013 to Feb.2014.One hundred and fourteen patients met the inclusion criteria with gestational ages from 32 to 36 weeks at birth,including 54 SGA infants and 60 AGA infants.The aEEG recordings were obtained within 72 h after birth by using the NicoletOne monitor.Duration of each recording was at least 3 h.Five aspects of each tracing,such as continuity (Co),sleep-wake cycling (Cy),amplitude of the lower border (LB),bandwidth (B) and total maturation scores,were evaluated and compared between 2 groups by applying a aEEG scoring system.Results 1.As SGA infants,scores for Co,Cy,LB,B as well as total maturation scores were progressively increased with gestational age advancing(all P ＜ 0.05).As AGA infants,scores for Cy,B and total maturation scores progressively increased with advancing gestational age (all P ＜ 0.05),but there were no statistical differences between each gestational ages in Co,LB scores (all P ＞ 0.05).2.Linear regression analysis of SGA infants' gestational age to Co,Cy,LB,B and total maturation scores showed positively correlation,and the correlation coefficients were 0.438,0.597,0.385,0.606 and 0.608,respectively (all P ＜ 0.05).As AGA infants,a positive correlation between gestational age and Cy,B as well as total maturation scores were observed,and the correlation coefficients were 0.528,0.615 and 0.635,respectively (all P ＜ 0.05).3.At the same gestational age,both the B scores and total maturation scores in SGA group were lower than those in AGA group.Conclusions SGA and AGA,Co,Cy and total maturation scores can be used to evaluate the maturation of cerebral function.At the same gestational age,the scores of B and total maturation scores are lower in the SGA,and this might be associated with their delayed neuromotor development.
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Objective To observe effect of lidocaine pretreatment to malondialdehyde(MDA) and endothelin(ET) of patient ac-cepeted brain tumor removing and discuss the optimized pretreatment time .Methods 60 brain tumor patients in the hospital from March 2009 to September 2011 .according to the different pretreatment time ,the patients were randomly divided into five groups :group A(preoperative 48 h) ,group B(preoperative 24 h) ,group C(preoperative 12 h) ,group D(0 h or anesthesia induced) ,group E (control group) and group F(blank control group) ,10 cases in each group .Group A ,B ,C ,D with 1% lidocaine 1 .5 mg/kg intrave-nous pretreatment on schedule ,then induced conventional anesthesia ;group E were supplemented with 1% lidocaine 2 .5 mg · kg -1 · h-1 intravenous injection after anesthesia induction ;group F was performed routine program without lidocaine .The spontaneous breathing time ,awake time and tracheal extubation time was recorded ,while NIHSS score for evaluation of neural function defect was applied ,and peripheral serum level of MDA and ET was detected by colorimetric technique and radio-immunity .Results In group C ,the spontaneous breathing time ,awake time and tracheal extubation time were shorter than other groups ,but the difference had no statistically significant(P>0 .05) .There was no significant difference among each group in the aspect of NIHSS score 1 day before surgery(P>0 .05) ,after 14 days of operation ,NIHSS of group C was statistically lower than that of group E and group F (P 0 .05) .MDA and ET content in group C was significantly lower than those in other groups after surgery (P<0 .05) .Conclusion Lidocaine given 12 h before cere-bral ischemia has varying degree protection against cerebral ischemia-reperfusion injury .The protection has relation with the de-crease of MDA and ET content .
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The prevention of myocardial and brain dysfunction induced by positive acceleration (+Gz) exposure is the focus in the field of aerospace medicine research topic .The characteristics and mechanisms that +Gz exposure caused damages to vital organs such as heart and brain remain to be further elucidated .The research literature about +Gz acceleration exposure-induced heart and brain injuries in experimental animals and its mechanisms at home and abroad was reviewed in this paper .
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Objective To investigate the effect of Tetramethylpyrazine (extracted from Chinese herbal medicine Ligusticum wallichii) employed in the early stage of severe brain injury on the restoration of brain function in coma patients monitored with digitized cerebral state monitor and clinical signs.Methods A total of 364 patients were referred to us from Emergency Department and Neurosurgery Department,Shenzhen People's Hospital from January 2006 through May 2012.The scores of patients'GlasgowPittsburgh coma scales were between 7-20 as brain injury happened within 24 h and survived more than two weeks.All patients were randomly (random number) divided into two groups:Tetramethylpyrazine group (n =186) and control group (n =178).The patients of control group received routine treatment,and the patients of Tetramethylpyrazine group were treated with Tetramethylpyrazine in addition to routine treatment in early stage.The patients of two groups were assessed with cerebral state indexes (CSI) and GlasgowPittsburgh coma scales before treatment and 3,7,14 days after treatment.Statistical comparisons between groups were analyzed by using repeated measure design analysis of variance.Results A repeated measures design analysis of variance indicated that the CSI and clinical signs (Glasgow-Pittsburgh coma scale) were improved significantly in Tetramethylpyrazine group than those in the control group at 3,7,14 days after treatment (P =0.024).Conclusions Tetramethylpyrazine can protect brain function and improve clinical signs in patients with severe brain injury in the early stage.
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Objective To investigate the efficacy of amplitude-integrated electroencephalographic (aEEG)in evaluating the maturation of cerebral function in preterm infants.Methods Ninety one neurologically normal and clinically stable preterm infants admitted to neonatal intensive care unit were studied prospectively by using aEEG.Background of aEEG activity patterns,presence of sleep-wake cycles,and the lower and higher border were analyzed.Results 112 aEEG were analyzed.The sleep-wake cycle and the continuity became more mature with PMA increased.The lower border were increased and the higher border were decreased with PMA increased(r =0.982,P ＜ 0.01 ; r =-0.964,P＜0.01).Conclusion In preterm infants,aEEG is a useful tool to evaluate the maturation of cerebral function.
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@#Objective To explore the characteristics of brain function in rats with Stagnation of Liver-qi Syndrome. Methods Model ofStagnation of Liver-qi was made with chronic stress combined with isolated raising in 10 normal Wistar rats. They were scanned with positronemission tomography (PET) before and after modeling. Data analysis was carried out using SPM (statistical parametric mapping 2) inMATLAB software. Results After modeling, the glucose metabolism decreased (P<0.001) in left frontal lobe, parietal lobe, hypothalamus;bilateral posterior cingulate; right anterior cingulate, while the glucose metabolism increased (P<0.001) in left parahippocampal gyrus, insula,temporal lobe, frontal lobe; right basal ganglia, thalamus. Conclusion The function of some cerebral areas can be changed undergoingStagnation of Liver-qi Syndrome.
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The successful anaesthetic management using a cervical epidural technique is reported in patients undergoing carotid artery surgery. Adequate analgesia is obtained and the adequacy of cerebral blood flow is easily judged by the patient’s state of consciousness. Cervical epidural anaesthesia could be a safe and reasonable technique for the management of patients who need carotid artery surgery.1 A 54 years old man of A.S.A (American Society of Anesthesiologists) grade- II underwent carotid endarterectomy under Cervical Epidural Anaesthesia (CEA) at C7 – T1 level using a mixture of 0.5% Lidocaine, 0.25% Bupivacaine and Fentanyl citrate. Standard peroperative monitoring including invasive arterial blood pressure and arterial blood gas analysis was done.
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@#Objective To compare the efficacy and safety of the target controlled administration of sufentanil and intermittent sufentanil during awake craniotomy. Methods 40 patients were randomized into target controlled infusion of sufentanil group (n=20) and intermittent sufentanil group (n=20) and compared. Results The hemodynamic parameters were similar in the two groups. However, target controlled infusion of sufentanil was associated with significantly lower respiratory rate （P<0.05）, higher end tidal CO2 （P<0.05）, and higher dosage of sufentanil （P<0.01）, compared with those of intermittent sufentanil. Conclusion Intermittent sufentanil infusion is associated with less respiratory depression than target controlled administration of sufentanil in awake craniotomy.
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@#Exercise can improve the recovery of neural functions following ischemia in rats.The outcome is related to the injury severity, the intervention time, Methods and intensity. The time window can directly influence rehabilitation outcome.Various kinds of rehabilitative Methods may promote neural plasticity. And intensity has correlation with rehabilitation outcome. In this article, we discuss the effects of optimal intervention time for exercise, the Methods and the intensity to the recovery of neural functions in rat.
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@#Objective To explore the characteristics of patients with stagnation of liver-qi syndrome using brain functional imaging techniques.Methods10 patients with stagnation of liver-qi syndrome and 20 normal persons whom paired by sex and age were scanned with positron emission tomography(PET).Data analysis was carried out using SPM in MATLAB software.ResultsCompared with normal,some cerebral areas of the patients with stagnation of liver-qi syndrome showed glucose metabolism letdown(P<0.001),including right parietal lobe(postcentral gyrus,BA1/2),temporal lobe(middle temporal gyrus,BA37),frontal lobe(middle frontal gyrus,BA9/10)etc.,while some cerebral areas showed glucose metabolism heighten(P<0.001)including right frontal lobe(superior frontal gyrus,inferior fontal gyrus,BA22/28/44),right cingulated gyrus,double midbrain and cerebella,etc.ConclusionThe function of some cerebral areas can be changed undergoing stagnation of liver-qi syndrome.
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Objective To evaluate the role of cerebral state index(CSI),burst suppression (BS)and electromyograph(EMG)in monitoring coma/consciousness depth and damage degree of brain. Methods CSM was done in 50 cases with brain injury and coma to analyze its relation with physical reflection,auditory evoked potential(AEP),Glasgow coma score(GCS)and Glasgow outcome scale (GOS).Results As scale range meaning from consciousness to deep coma and to brain death,CSI 0- 100 was positively correlated with coma depth,coma score of GCS and physical reflection.CSI changes under invariable ache stimulation in combination with BS and EMG can accurately estimate prognosis and quantify changes of brain function.Conclusions The quantifiable digit of coma/consciousness depth and damage degree in brain function by CSM can attain real time judgment of dynamic evolvement course of coma and objective guide clinical therapy and assure prognosis,as will change absolutely scoring coma/ consciousness depth and prognosis under current state of artificial diversity and lacking objective evi- dences.