Simulation-based training of critical events during cardiopulmonary bypass: importance of a critical events checklist

Perfusion ◽  
2020 ◽  
pp. 026765912093712
Author(s):  
Frank Merkle ◽  
Dino Kurtovic ◽  
Andreas Matschke ◽  
Benjamin Haupt ◽  
Volkmar Falk ◽  
...  
Keyword(s):  
Decision Making ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiopulmonary Bypass ◽  
Eye Tracking ◽  
Critical Event ◽  
Correct Decision ◽  
Critical Events ◽  
Educational Approach ◽  
Areas Of Interest

Objectives: Evaluation of critical events training for clinical perfusionists is necessary to improve this educational approach. Critical events checklists are effective in reducing clinical complications, but should be tested in a simulation environment first. Individual behavior and stress response of clinical perfusionists during simulated critical events on cardiopulmonary bypass have not been evaluated yet. This study focuses on the evaluation of critical events training and critical events checklists in simulated cardiopulmonary bypass. Methods: A total of 19 clinical perfusionists from a single hospital took part in two simulated critical event scenarios. Clinical perfusionist behavior and physiological responses were recorded using eye tracking, heart rate variability, video, and audio. In addition, workloads were determined and participants were interviewed. Results: Relevant areas of interest were identified for each simulation phase. During critical event detection and subsequent decision-making, areas of interest hits and fixation durations varied with the use of a critical events checklist. Times to decision were shorter, decision quality was higher, and temporal workload was increased when the checklist was used. Evaluation of selected heart rate variability measures revealed a good correlation with pupil diameters. Conclusion: Evaluation of critical events during simulated cardiopulmonary bypass shows that the scenario is realistic and relevant for clinical practice. Integrating a critical events checklist improves the probability of correct decision-making and shortens the correct decision time. Temporal workload is increased when using a checklist. Eye tracking and heart rate variability are well suited to evaluate participants’ behaviors and stress levels. All participants welcomed simulation training for critical incidents.

scholarly journals Heart Rate Variability and Decision-Making: Autonomic Responses in Making Decisions

2021 ◽  
Vol 11 (2) ◽  
pp. 243
Author(s):  
Giuseppe Forte ◽  
Matteo Morelli ◽  
Maria Casagrande
Keyword(s):  
Decision Making ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cognitive Processes ◽  
Iowa Gambling Task ◽  
Decision Makers ◽  
Good Decision ◽  
Valid Index ◽  
Inhibitory Circuit ◽  
The Relationship

Decision-making is one of the most crucial cognitive processes in daily life. An adaptable, rapid, and flexible decision requires integration between brain and body. Heart rate variability (HRV) indexes this brain–body connection and appears to be related to cognitive performance. However, its relationship with decision-making is poorly analyzed. This study investigates the relationship between HRV and the decision-making process, assessed through the Iowa Gambling Task (IGT). One hundred and thirty healthy university students (mean age = 23.35 ± 2.50) participated in the study. According to IGT performance, they were divided into high decision-makers (n = 79) and low decision-makers (n = 51). Heart rate variability was measured in the resting, reactivity (i.e., during IGT), and recovery phases. Higher vagally mediated HRV (vmHRV; indexed in frequency domain measures) was evidenced in good decision-makers in the resting, reactivity, and recovery phases. During the task, a higher vagal modulation after a first evaluation was highlighted in good decision-makers. In conclusion, HRV proves to be a valid index of inhibitory circuit functioning in the prefrontal cortex. The relationship with cognitive functions was also confirmed, considering the ability to inhibit disadvantageous responses and make better decisions.

scholarly journals An Exploratory Application of Eye-Tracking Methods in a Discrete Choice Experiment

2018 ◽  
Vol 38 (6) ◽  
pp. 658-672 ◽  
Author(s):  
Caroline Vass ◽  
Dan Rigby ◽  
Kelly Tate ◽  
Andrew Stewart ◽  
Katherine Payne
Keyword(s):  
Decision Making ◽  
Eye Tracking ◽  
Risk Communication ◽  
Discrete Choice ◽  
Dwell Time ◽  
Ordinary Least Squares ◽  
Discrete Choice Experiments ◽  
Tracking Data ◽  
Significant Difference ◽  
Areas Of Interest

Background. Discrete choice experiments (DCEs) are increasingly used to elicit preferences for benefit-risk tradeoffs. The primary aim of this study was to explore how eye-tracking methods can be used to understand DCE respondents’ decision-making strategies. A secondary aim was to explore if the presentation and communication of risk affected respondents’ choices. Method. Two versions of a DCE were designed to understand the preferences of female members of the public for breast screening that varied in how risk attributes were presented. Risk was communicated as either 1) percentages or 2) icon arrays and percentages. Eye-tracking equipment recorded eye movements 1000 times a second. A debriefing survey collected sociodemographics and self-reported attribute nonattendance (ANA) data. A heteroskedastic conditional logit model analyzed DCE data. Eye-tracking data on pupil size, direction of motion, and total visual attention (dwell time) to predefined areas of interest were analyzed using ordinary least squares regressions. Results. Forty women completed the DCE with eye-tracking. There was no statistically significant difference in attention (fixations) to attributes between the risk communication formats. Respondents completing either version of the DCE with the alternatives presented in columns made more horizontal (left-right) saccades than vertical (up-down). Eye-tracking data confirmed self-reported ANA to the risk attributes with a 40% reduction in mean dwell time to the “probability of detecting a cancer” ( P = 0.001) and a 25% reduction to the “risk of unnecessary follow-up” ( P = 0.008). Conclusion. This study is one of the first to show how eye-tracking can be used to understand responses to a health care DCE and highlighted the potential impact of risk communication on respondents’ decision-making strategies. The results suggested self-reported ANA to cost attributes may not be reliable.

scholarly journals Heart rate variability and interoceptive accuracy predict impaired decision-making in Gambling Disorder

2021 ◽  
Author(s):  
Lorenzo Moccia ◽  
Maria Quintigliano ◽  
Delfina Janiri ◽  
Valentina De Martin ◽  
Guyonne Rogier ◽  
...  
Keyword(s):  
Decision Making ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Linear Regression ◽  
Regression Model ◽  
Linear Regression Model ◽  
Gambling Disorder ◽  
Slot Machines ◽  
Interoceptive Accuracy ◽  
The Impact

Abstract Background and aims Gambling Disorder (GD) entails maladaptive patterns of decision-making. Neurophysiological research points out the effect of parasympathetic arousal, including phasic changes in heart rate variability (HRV), and interoceptive accuracy (IA, i.e., the ability to track changes in bodily signals), on decision-making. Nevertheless, scarce evidence is available on their role in GD. This is the first study exploring the impact in GD of respiratory sinus arrhythmia (RSA), an index of HRV, and IA on decision-making, as measured by the Iowa Gambling Task (IGT). Methods Twenty-two patients experiencing problems with slot-machines or video lottery terminals gambling and 22 gender- and age-matched healthy controls (HC) were recruited. A resting ECG was performed before and after the completion of the IGT. IA was assessed throughout the heartbeat detection task. We conducted a MANCOVA to detect the presence of significant differences between groups in RSA reactivity and IA. A linear regression model was adopted to test the effect of factors of interest on IGT scores. Results Patients with GD displayed significantly decreased RSA reactivity (P = 0.002) and IA (P = 0.024) compared to HCs, even after controlling for affective symptoms, age, smoking status, and BMI. According to the linear regression model, cardiac vagal reactivity and IA significantly predict decision-making impairments on the IGT (P = 0.008; P = 0.019). Discussion and conclusions Although the exact pathways linking HRV and IA to impaired decision-making in GD remain to be identified, a broader exploration relying upon an embodiment-informed framework may contribute to shed further light on the clinical phenomenology of the disorder.

Anxiety, attention, and decision making: The moderating role of heart rate variability

2015 ◽  
Vol 98 (3) ◽  
pp. 490-496 ◽  
Author(s):  
Encarnación Ramírez ◽  
Ana Raquel Ortega ◽  
Gustavo A. Reyes Del Paso
Keyword(s):  
Decision Making ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Moderating Role

Analysis of neonatal resuscitation using eye tracking: a pilot study

2017 ◽  
Vol 103 (1) ◽  
pp. F82-F84 ◽  
Author(s):  
Brenda Hiu Yan Law ◽  
Po-Yin Cheung ◽  
Michael Wagner ◽  
Sylvia van Os ◽  
Bin Zheng ◽  
...  
Keyword(s):  
Decision Making ◽  
Pilot Study ◽  
Eye Tracking ◽  
Situation Awareness ◽  
Human Performance ◽  
Healthcare Providers ◽  
Neonatal Resuscitation ◽  
Video Recordings ◽  
Acceptable Quality ◽  
Areas Of Interest

BackgroundVisual attention (VA) is important for situation awareness and decision-making. Eye tracking can be used to analyse the VA of healthcare providers. No study has examined eye tracking during neonatal resuscitation.ObjectiveTo test the use of eye tracking to examine VA during neonatal resuscitation.MethodsSix video recordings were obtained using eye tracking glasses worn by resuscitators during the first 5 min of neonatal resuscitation. Videos were analysed to obtain (i) areas of interest (AOIs), (ii) time spent on each AOI and (iii) frequency of saccades between AOIs.ResultsFive videos were of acceptable quality and analysed. Only 35% of VA was directed at the infant, with 33% at patient monitors and gauges. There were frequent saccades (0.45/s) and most involved patient monitors.ConclusionDuring neonatal resuscitation, VA is often directed away from the infant towards patient monitors. Eye tracking can be used to analyse human performance during neonatal resuscitation.

Blood pressure and heart rate variability changes during cardiac surgery with cardiopulmonary bypass

2004 ◽  
Vol 18 (3) ◽  
pp. 387-396 ◽  
Author(s):  
Edmundo P. Souza Neto ◽  
Joseph Loufouat ◽  
Christine Saroul ◽  
Christian Paultre ◽  
Pascal Chiari ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass

scholarly journals Monitoring stress and allostatic load in first responders and tactical operators using heart rate variability: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sean L. Corrigan ◽  
Spencer Roberts ◽  
Stuart Warmington ◽  
Jace Drain ◽  
Luana C. Main
Keyword(s):  
Decision Making ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Allostatic Load ◽  
First Responders ◽  
Stressful Events ◽  
Psychological Disorder ◽  
Occupational Stressors ◽  
First Responder ◽  
Eligibility Criteria

Abstract Background Awareness of the cumulative stress placed on first responders and tactical operators is required to manage acute fatigue, which can impair occupational performance, and may precipitate negative chronic health outcomes. The aim of this review was to investigate the utility of heart rate variability (HRV) to monitor stress and allostatic load among these populations. Methods A systematic search of Academic Search Complete, MEDLINE complete, PsycINFO, SPORTDiscus and Scopus databases was conducted. Eligibility criteria: original peer reviewed research articles, written in English, published between 1985 and 2020, using human participants employed as a first responder or tactical operator, free from any psychological disorder. Results Of the 360 articles screened, 60 met the inclusion criteria and were included for full text assessment. Articles were classified based on single or repeated stressor exposure and the time of HRV assessment (baseline, during stressor, post stressor). Singular stressful events elicited a reduction in HRV from baseline to during the event. Stressors of greater magnitude reduced HRV for extended durations post stressor. Lower resting HRV was associated with lower situational awareness and impaired decision-making performance in marksmanship and navigation tasks. There were insufficient studies to evaluate the utility of HRV to assess allostatic load in repeated stressor contexts. Conclusion A reduction in HRV occurred in response to acute physical and cognitive occupational stressors. A slower rate of recovery of HRV after the completion of acute occupational stressors appears to occur in response to stressors of greater magnitude. The association between lower HRV and lower decision-making performance poses as a useful tool but further investigations on within subject changes between these factors and their relationship is required. More research is required to investigate the suitability of HRV as a measure of allostatic load in repeated stress exposures for fatigue management in first responder and tactical operators.

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