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 2008
A target control Infusion method for neuromuscular blockade based on hybrid parameter estimation.
The paper presents a new method for target control infusion (TCI) for neuromuscular blockade (NMB) level control of patients subject to general anaesthesia. The method combines an inversion of the pharmacokinetic/pharmacodynamic (PK/PD) model with a hybrid parameter estimation method that uses on-line data from the initial bolus response to estimate the model parameters. Although atracurium is considered as relaxant, the newly proposed method may be applied to other drugs for which the PK/PD model is available. Simulation results on a bank of 100 patient models are presented to demonstrate the achievable performance.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2008
Autonomic nervous system response to vibrating and electrical stimuli on the forearm and wrist.
In today's operating rooms, anesthesiologists use physiological data monitoring systems with visual and auditory cues to receive patient information. The efficacy of these visual-audio systems is limited by the human limitations of these modalities. Previous studies have shown the potential use of a complementary, or alternate, patient data monitoring technology utilizing another psychophysically relevant modality: the sense of touch via vibro-tactile or electro-tactile stimulation. ⋯ Using the LifeShirt, system, electrocardiogram (ECG), respiratory rate (Br), tidal volume (Vt) data were collected. Results showed a higher value of the heart rate and heart rate variability (HRV) when using the VF compared to the VW and EF. We also found that the HRV response for the three tactile prototypes was correlated with the accuracy of tactile pattern identification.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2008
Usefulness of monitoring congestive heart failure by multiple impedance vectors.
We investigated trends in intrathoracic impedance measured between multiple implanted electrodes for monitoring pulmonary edema secondary to congestive heart failure (CHF) in an experimental model. ⋯ All impedance vectors decreased during CHF. Impedance measurement employing left heart sensors correlated well wit- - h LA pressure, and may improve detection of CHF onset compared to sensing by RA or RV leads alone. This approach has important clinical implications for managing heart failure patients in the ambulatory setting.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2008
Asymmetry in lung sound intensities detected by respiratory acoustic thoracic imaging (RATHI) and clinical pulmonary auscultation.
RATHI was introduced as an attempt to further improve the association between anatomical zones and specific breathing activity, both spatially and temporally. This work compares RATHI with clinical pulmonary auscultation (PA) to assess the concordance between both procedures to detect asymmetries in lung sound (LS) intensities. Twelve healthy young males participated in the study and were auscultated by two experts. ⋯ By RATHI, most of the subjects showed asymmetries between apical and basal regions higher than 20%, whereas between left and right hemithorax asymmetries higher than 20% occurred only half of the time. RATHI and PA agreed 83 to 100% when apical to base acoustical information was compared, but when left to right asymmetries were considered these figures were about 40 to 50%. We concluded that RATHI has advantages as it gave more detailed and measurable information on LS than clinicians, who could not detect intensity asymmetries mainly below 20%.
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Low bandwidth has long been a reason for the unsuitability of wireless internet in telemedicine. However with the advent of extended third generation wireless as an economically accessible high speed network, more opportunities are being created in this area of telemedicine. This paper explores the opportunity created by the latest wireless broadband technology for remote monitoring of patients in the home.