Computed tomography (CT) is widely used to evaluate emergency department (ED) patients with headache, increasing costs, radiation exposure, and workload. Non-invasive intracranial pressure waveform (ICPW) monitoring has been proposed as an adjunctive triage tool. We assessed its diagnostic performance for identifying abnormal head CT findings in ED patients with red-flag headaches and explored potential resource implications. This retrospective study included 84 patients with red-flag headaches at Hospital Leforte Morumbi, Brazil (June–September 2023). All underwent non-invasive ICPW monitoring (brain4care System) and head CT during the same ED encounter. ICPW was abnormal if P2/P1 ≥ 1.2 or time-to-peak (TTP) ≥ 0.3. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated against abnormal CT. CT expenditure and ED length of stay were assessed as exploratory outcomes. ICPW showed 90.0
Peripheral intravenous (IV) catheter infiltration is a common complication which can cause harmful extravasation of fluid and medications. Significant injury can occur before standard infusion pumps detect a threshold pressure. Peripheral IV waveform analysis (PIVA) uses fast Fourier transform (FFT) to measure the amplitude of the venous waveform. This study aims to evaluate if PIVA can differentiate between IV catheter positions, primarily intravenous versus subcutaneous, in a rat model. Surgical cutdown was performed on the right proximal saphenous vein. Pressure and waveforms were recorded from a 22G IV catheter open-to-air, in the vein, and in the adjacent subcutaneous (SC) tissue. Measurements were performed at baseline and after injection of 1 mL Plasmalyte and are reported as median (interquartile range). The peak amplitude corresponding to the heart rate frequency labeled as f1. Pre-flush intravascular f1, 0.0824 mmHg (IQR 0.0256, 0.1480), differed significantly from both SC, 0.0001 mmHg (0.0000, 0.0004), and open-to-air, 0.0001 mmHg (0.0000, 0.0008), conditions, ANOVA p = 0.03, pairwise p = 0.049 and 0.049, respectively. These significant differences remained after flush. Post-flush pressures between IV, 7.9 mmHg (6.6, 8.9) and SC, 20.5 mmHg (11.3, 28.8) were significantly different, p = 0.0001. There was no significant difference in pre-flush and post-flush pressure within IV, SC, and open-air groups, p = 0.687, p = 0.110 and p = 0.219, respectively. PIVA was superior to absolute pressure measurement for detecting intravascular versus extravascular placement of an IV catheter. This study demonstrates utility of PIVA as a novel method for confirming proper IV placement.
Accurate, continuous blood pressure (BP) monitoring is important for preventing, diagnosing, and managing cardiovascular disease. Estimating the full arterial BP waveform can provide more clinical information than cuff-based measurements that report only systolic and diastolic BP. This review summarizes recent progress in predicting arterial BP waveforms from photoplethysmography (PPG) and identifies the main methodological gaps that limit clinical translation. We reviewed research published since 2021 on PPG-based BP waveform estimation. We organized the literature around core pipeline elements, including open-source datasets, preprocessing and quality control, model architectures, and validation practices. We also surveyed commercially available technologies that measure BP waveform. Data cleaning approaches can be grouped into three main categories: (1) template-based pulsation comparison, (2) feature extraction paired with classical machine learning, and (3) neural network–based quality assessment. For waveform prediction, recent work is dominated by deep learning, particularly U-Net–based architectures, autoencoder families, and attention-based models. Progress in PPG-based BP waveform prediction is rapid, but comparability and reproducibility remain major barriers. Benchmark datasets with consistent acquisition protocols, transparent preprocessing, and standardized validation criteria are needed to support fair comparison.
Quantitative neuromuscular (qNM) monitoring is recommended whenever neuromuscular blocking agents (NMBAs) are administered, but adherence in routine clinical practice remains inconsistent. This audit evaluated adherence to recommended qNM monitoring standards in adult patients undergoing general anesthesia at a Portuguese tertiary hospital. This prospective clinical audit evaluated adherence to recommended qNM monitoring standards in adult patients undergoing general anesthesia at a major Portuguese tertiary hospital. Over five predefined weekdays between March and May 2025, all adult patients receiving general anesthesia across six operating or procedural areas were assessed. Of 329 patients included, 308 (93.6
