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 2011
iSyNCC: an intelligent system for patient monitoring & clinical decision support in Neuro-Critical-Care.
Close monitoring and timely treatment are extremely crucial in Neuro Intensive/Critical Care Units (NICUs) to prevent patients from secondary brain damages. However, the current clinical practice is labor-intensive, prone to human errors and ineffective. ⋯ The requirements of the system were investigated through interviews and discussions with neurosurgeons, neuroclinicians and nurses. Based on the summarized requirements, a modular 2-tier system is developed. iSyNCC integrates and stores crucial patient information ranging from demographic details, clinical & treatment records to continuous physiological monitoring data. iSyNCC enables remote and centralized patient monitoring and provides computational intelligence to facilitate clinical decision makings.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2011
Selective co-stimulation of pudendal afferents enhances reflex bladder activation.
The loss of normal bladder function is common in persons with spinal cord injury (SCI) and negatively impacts their quality of life. Electrical stimulation of pudendal nerve afferents is a promising approach to restore control of bladder function. Pudendal afferent stimulation can generate reflex contraction of the bladder, but the resulting bladder voiding efficiency remains low. ⋯ In preclinical studies in anesthetized adult cats, co-stimulation of CSN and DNP evoked larger bladder contractions than individual stimulation of either CSN or DNP. In a parallel clinical experiment involving a participant with chronic SCI, co-stimulation of the proximal and distal urethra also produced synergistic augmentation of reflex bladder activity, and thus improved voiding efficiency when compared to reflex distension-evoked voiding. Selective co-stimulation of pudendal afferents is efficacious and should be considered in the development of neural prosthetics for restoration of bladder function in persons with SCI.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2011
EMG contributes to improve Cerebral State Index modeling in dogs anesthesia.
Cerebral State Index (CSI) is a measure of depth of anesthesia (DoA) developed for humans, which is traditionally modeled with the Hill equation and the propofol effect-site concentration (Ce). The CSI has been studied in dogs and showed several limitations related to the interpretation of EEG data. Nevertheless, the CSI has a lot of potential for DoA monitoring in dogs, it just needs to be adjusted for this species. ⋯ In fact, the EMG introduction in CSI model significantly decreased the modeling error: 11.8 [8.6; 15.2] (fuzzy logic) versus 20.9 [16.4; 29.0] (Hill). This work shows that CSI modeling in dogs can be improved using the current human anesthesia set-up, once the EMG signal is acquired simultaneously with the CSI index. However, it does not invalidate the search of new DoA indices more adjusted to use in dog's anesthesia.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2011
Sequential versus concurrent computation of complex model systems for medical decision support.
Medical Decision Support Systems employ mathematical models to optimize therapy settings. The mathematical models are used to predict patient reactions towards alteration in the therapy regime. This prediction should not be limited to one detail but should feature a broad picture. ⋯ Evaluation of the new approach showed that results feature a discrepancy lower than 2.5% compared to the results computed by the concurrent approach. Simulation error could be decreased to 2% by improving the precalculation of the interface signals. Computing costs have been decreased by a factor of 17.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2011
Long-term performance of a CE-approved telemetric intracranial pressure monitoring.
Telemetric intracranial pressure (ICP) monitoring has been a challenge throughout several decades. Major obstruction was to minimize zero drift of absolute pressure sensors. A new promising product demonstrating in-vitro excellent long-term stability has been tested for its reliability in an animal model with a follow-up of up to 2 years. ⋯ The zero-shift was -1.7 ± 7.6 mm Hg (limits of agreement: 4.4 ± 1.9 mm Hg) and -3.0 ± 6.0 mm Hg (limits of agreement: 3.6 ± 2.6 mm Hg) in STel and PTel respectively meeting well the devices specification of ± 2 mm Hg drift per year. The reliability of both telemetric probes has been proved as quite comparable (p=0.2). These new telemetric ICP probes demonstrate reliable data during at least the first 6 months after implantation.