Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference
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Conf Proc IEEE Eng Med Biol Soc · Jan 2007
Control of depth of anesthesia using MUSMAR--exploring electromyography and the analgesic dose as accessible disturbances.
The problem of controlling the level of depth of anesthesia measured by the Bispectral Index (BIS) of the electroencephalogram of patients under general anesthesia, is considered. It is assumed that the manipulated variable is the infusion rate of the hypnotic drug propofol, while the drug remifentanil is also administered for analgesia. ⋯ The performance of the controller is illustrated by means of simulation with 45 patient individual adjusted models, which incorporate the effect of the drugs interaction on BIS. This controller structure proved to be robust to the EMG and remifentanil disturbances, patient variability, changing reference values and noise.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2007
Using standards to automate electronic health records (EHRs) and to create integrated healthcare enterprises.
President Bush's 2004 Executive Order mandated the creation within the Secretary of Health and Human Services' staff of a new Office of the National Coordinator for Healthcare Information Technology (ONCHIT) that was tasked with creating the United States National Healthcare Information Network (NHIN). The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the 2004 and a subsequent 2006 Executive Orders have finally set the stage to design, and require, the use of standardized, electronic data interchange-enabled information systems as quickly as possible.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2007
Local control of temperature in a theoretical human model of selective brain cooling.
A method of feedback control of local brain temperature during therapeutic intracarotid cold saline infusion is presented and tested on a theoretical cerebral heat transfer model based on the Pennes bioheat equation. In this temperature control method, the infusion rate of cold saline is varied based on the rate of temperature change, and the deviation of temperature to a target, within a voxel in the treated region of brain. ⋯ Two hours of treatment decreased the required inflow of ice-cold saline from 30 ml/min to 21 and 7 ml/min in the non-ice and ice cases, respectively. Intracarotid hematocrit had higher values in the non-ice case.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2007
Randomized Controlled TrialA new method for evaluating the performance of depth-of-hypnosis indices - the D-value.
An alternative statistic, the D-value, is presented for the evaluation of the performance of EEG-based depth-of-hypnosis measures against the Observers' Assessment of Alertness/Sedation scale. The measures considered here are spectral entropy, approximate entropy, Lempel-Ziv complexity and Higuchi fractal dimension. The study is based on recordings from 45 patients, divided into three groups of 15 recordings each. ⋯ All the patients received stepwise increased dose of propofol. The study shows that the D-value is a promising and flexible statistic for the evaluation of the discriminative power of the EEG measures with respect to the OAA/S scale. The D-value indicates well the dependence of the performance of the measures on the EEG frequency band as well as on remifentanil concentration.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2007
Optimizing the tactile display of physiological information: vibro-tactile vs. electro-tactile stimulation, and forearm or wrist location.
Anesthesiologists use physiological data monitoring systems with visual and auditory displays of information to monitor patients in the operating room (OR). The efficacy of visual-audio systems may impose an increase in patient risk when the demand for constant switching of attention between the patient and the visual monitoring system is high. This is evidenced by auditory alarms frequently being neglected in a noisy OR environment. ⋯ A post-study questionnaire was completed by each subject to assess the comfort and usability of the three prototypes. We found that both VF and VW were superior to the EF in both accuracy and comfort and, that there were no differences between the wrist and the forearm. In conclusion, the tactile-display prototypes designed to alert the clinician of adverse changes in a patient's physiological state efficaciously and unobtrusively delivered these data and warranted further investigation and development.