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 2009
Data mining of patients on weaning trials from mechanical ventilation using cluster analysis and neural networks.
The process of weaning from mechanical ventilation is one of the challenges in intensive care. 149 patients under extubation process (T-tube test) were studied: 88 patients with successful trials (group S), 38 patients who failed to maintain spontaneous breathing and were reconnected (group F), and 23 patients with successful test but that had to be reintubated before 48 hours (group R). Each patient was characterized using 8 time series and 6 statistics extracted from respiratory and cardiac signals. A moving window statistical analysis was applied obtaining for each patient a sequence of patterns of 48 features. ⋯ Neural networks were applied to discriminate between patients from groups S, F and R. The best performance obtained was 84.0% of well classified patients using a linear perceptron trained with a feature selection procedure (that selected 19 of the 48 features) and taking as input the main cluster centroid. However, the classification baseline 69.8% could not be improved when using the original set of patterns instead of the centroids to classify the patients.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Pulse pressure variation estimation using a sequential Monte Carlo method.
We describe a novel automatic algorithm to continuously estimate the pulse pressure variation (PPV) index from arterial blood pressure (ABP) signals. The algorithm utilizes our recently developed sequential Monte Carlo method (SMCM) based on a maximum A-Posterior adaptive marginalized particle filter (MAM-PF). The PPV index is one of most specific and sensitive dynamic indicators of fluid responsiveness in mechanically ventilated patients. We report the assessment results of the proposed algorithm on real ABP signals.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Medical safety of TASER conducted energy weapon in a hybrid 3-point deployment mode.
TASER conducted energy weapons (CEW) deliver electrical pulses that can temporarily incapacitate subjects. The goal of this paper is to analyze the distribution of TASER CEW currents in the heart and surrounding organs and to understand theoretical chances of triggering cardiac arrhythmias, of capturing the vagus and phrenic nerves and producing electroporation of skeletal muscle structures. The CEW operates in either probe mode or drive-stun (direct contact) mode. There is also a hybrid mode in which current is passed from a single probe to either or both of 2 drive-stun electrodes on the weapon, presumed to be in direct contact with the skin. ⋯ Numerical modeling estimated that TASER CEWs were expected to be safe when deployed in 3-point mode. In drive-stun, probe-mode or 3-point deployments, the CEWs had high theoretically approximated safety margins for cardiac capture, VF, phrenic or vagus nerve capture and skeletal muscle damage by electroporation.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Automated beat onset and peak detection algorithm for field-collected photoplethysmograms.
Recent reports suggest that photoplethysmography (PPG), which is a component of routine pulse oximetry, may be useful for detecting hypovolemia. An essential step in extracting and analyzing common PPG features is the robust identification of onset and peak locations of the vascular beats, despite varying beat morphologies and major oscillations in the baseline. Some prior reports used manual analysis of the PPG waveform; however, for systematic widespread use, an automated method is required. ⋯ We validated the algorithm by clinician evaluation of 100 randomly selected PPG waveform samples. For 99% of the beats, the algorithm was able to credibly identify the onsets and peaks of vascular beats, although the precise locations were ambiguous, given the very noisy data from actual clinical operations. The algorithm appears promising, and future consideration of its diagnostic capabilities and limitations is warranted.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Electrode design for high frequency block: effect of bipolar separation on block thresholds and the onset response.
The delivery of high frequency alternating currents (HFAC) to peripheral nerves has been shown to produce a rapid and reversible nerve conduction block at the site of the electrode, and holds therapeutic promise for diseases associated with undesired or pathological neural activity. It has been known since 1939 that the configuration of an electrode used for nerve block can impact the quality of the block, but to date no formal study of the impact of electrode design on high frequency nerve block has been performed. Using a mammalian small animal model, it is demonstrated that the contact separation distance for a bipolar nerve cuff electrode can impact two important factors related to high frequency nerve block: the amplitude of HFAC required to block the nerve (block threshold), and the degree to which the transient "onset response" which always occurs when HFAC is first applied to peripheral nerves, is present. This study suggests that a bipolar electrode with a separation distance of 1.0 mm minimizes current delivery while producing high frequency block with a minimal onset response in the rat sciatic nerve.