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Tidal volume monitoring may help minimize lung injury during respiratory assistance. Surface imaging using time-of-flight camera is a new, non-invasive, non-contact, radiation-free, and easy-to-use technique that enables tidal volume and respiratory rate measurements. The objectives of the study were to determine the accuracy of Time-of-Flight volume (VTTOF) and respiratory rate (RRTOF) measurements at the bedside, and to validate its application for spontaneously breathing patients under high flow nasal canula. Data analysis was performed within the ReaSTOC data-warehousing project (ClinicalTrials.gov identifier NCT02893462). All data were recorded using standard monitoring devices, and the computerized medical file. Time-of-flight technique used a Kinect V2 (Microsoft, Redmond, WA, USA) to acquire the distance information, based on measuring the phase delay between the emitted light-wave and received backscattered signals. 44 patients (32 under mechanical ventilation; 12 under high-flow nasal canula) were recorded. High correlation (r = 0.84; p 8 mL/kg) and low ventilation in 6 patients (tidal volume

Hypoxaemia and hyperoxaemia may occur after surgery, with related complications. This multicentre randomised trial evaluated the impact of automated closed-loop oxygen administration after high-risk abdominal or thoracic surgeries in terms of optimising the oxygen saturation measured by pulse oximetry time within target range.After extubation, patients with an intermediate to high risk of post-operative pulmonary complications were randomised to "standard" or "automated" closed-loop oxygen administration. The primary outcome was the percentage of time within the oxygenation range, during a 3-day frame. The secondary outcomes were the time with hypoxaemia and hyperoxaemia under oxygen.Among the 200 patients, time within range was higher in the automated group, both initially (≤3 h; 91.4±13.7%Automated closed-loop oxygen administration promotes greater time within the oxygenation target, as compared to standard manual administration, thus reducing the occurrence of hypoxaemia and hyperoxaemia.

IntroductionHypoxaemia and hyperoxaemia may occur after surgery, with related complications. This multicentre randomised trial evaluated the impact of automated closed-loop oxygen administration after high-risk abdominal or thoracic surgeries in terms of optimising the oxygen saturation measured by pulse oximetry time within target range.MethodsAfter extubation, patients with an intermediate to high risk of post-operative pulmonary complications were randomised to “standard” or “automated” closed-loop oxygen administration. The primary outcome was the percentage of time within the oxygenation range, during a 3-day frame. The secondary outcomes were the time with hypoxaemia and hyperoxaemia under oxygen.ResultsAmong the 200 patients, time within range was higher in the automated group, both initially (≤3 h; 91.4±13.7% versus 40.2±35.1% of time, difference +51.0% (95% CI −42.8–59.2%); pversus 62.1±23.3% of time, difference +31.9% (95% CI 26.3–37.4%); pversus 370.5±594.3 min (5.0±11.2%), difference −10.2% (95% CI −13.9–−6.6%); pversus 177.9±277.2 min (27.0±23.8%), difference −22.0% (95% CI −27.6–−16.4%); p10% of the entire monitoring time during the 3 days within the standard group, as compared to the automated group (pConclusionAutomated closed-loop oxygen administration promotes greater time within the oxygenation target, as compared to standard manual administration, thus reducing the occurrence of hypoxaemia and hyperoxaemia.

BackgroundRespiratory rate is among the first vital signs to change in deteriorating patients. The aims of this study were to evaluate the accuracy of respiratory rate measurements using a specifically dedicated reflection-mode photoplethysmographic signal analysis in a pathological condition (PPG-RR) and to validate its implementation within medical devices.MethodsThis study is derived from a data mining project, including all consecutive patients admitted to our ICU (ReaSTOC study, ClinicalTrials.gov identifier: NCT02893462). During the evaluation phase of the algorithm, PPG-RR calculations were retrospectively performed on PPG waveforms extracted from the data warehouse and compared with RR reference values. During the prospective phase, PPG-RR calculations were automatically and continuously performed using a dedicated device (FreeO2, Oxynov, Québec, QC, Canada). In all phases, reference RR was measured continuously using electrical thoracic impedance and chronometric evaluation (Manual-RR) over a 30-s period.ResultsIn total, 201 ICU patients’ recordings (SAPS II 51.7 ± 34.6) were analysed during the retrospective evaluation phase, most of them being admitted for a respiratory failure and requiring invasive mechanical ventilation. PPG-RR determination was available in 95.5% cases, similar to reference (22 ± 4 vs. 22 ± 5 c/min, respectively;p = 1), and well correlated with reference values (R = 0.952;p r = 0.78;p ConclusionAccording to our results, PPG-RR is an interesting approach for ventilation monitoring, as this technique would make simultaneous monitoring of respiratory rate and arterial oxygen saturation possible, thus minimizing the number of sensors attached to the patient.Trial registry numberClinicalTrials.gov identifier NCT02893462

IntroductionHypoxemia and hyperoxia may occur after surgery with potential related complications. The FreeO2PostOp trial is a prospective, multicentre, randomised controlled trial that evaluates the clinical impact of automated O2administration versus conventional O2therapy after major abdominal or thoracic surgeries. The study is powered to demonstrate benefits of automated oxygen titration and weaning in term of oxygenation, which is an important surrogate for complications after such interventions.Methods and analysisAfter extubation, patients are randomly assigned to theStandard(manual O2administration) orFreeO2group (automated closed-loop O2administration). Stratification is performed for the study centre and a medical history of chronic obstructive pulmonary disease (COPD). Primary outcome is the percentage of time spent in the target zone of oxygen saturation, during a 3-day time frame. In both groups, patients will benefit from continuous oximetry recordings. The target zone of oxygen saturation is SpO2=88%–92% for patients with COPD and 92%–96% for patients without COPD. Secondary outcomes are the nursing workload assessed by the number of manual O2flow adjustments, the time spent with severe desaturation (SpO22>98%), the time spent in a hyperoxia area (SpO2>98%), the VO2, the duration of oxygen administration during hospitalisation, the frequency of use of mechanical ventilation (invasive or non-invasive), the duration of the postrecovery room stay, the hospitalisation length of stay and the survival rate.Ethics and disseminationThe FreeO2PostOp study is conducted in accordance with the declaration of Helsinki and was registered on 11 September 2015 (http://www.clinicaltrials.gov). First patient inclusion was performed on 14 January 2016. The results of the study will be presented at academic conferences and submitted to peer-reviewed journals.Trial registration numberNCT02546830.