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
Pulse rate analysis in case of central sleep apnea: a new algorithm for cardiac rate estimation.
This paper first describes the AM-FM demodulation of an arterial pressure signal. Although it is known to be efficient on signals modulated by breathing, we demonstrate that in case of lack of respiratory modulation (real or simulated central sleep apnea), the AM-FM algorithm doesn't perform well in heart rate extraction. ⋯ The error for cardiac frequency estimation is around 0.2 BPM (Beats Per Minute) versus 5.5 BPM for the AM-FM demodulation. Further experimentations will be performed (with this time both cardiac and respiratory assessments) and will deal with real sleep apnea cases.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
FDA regulation of clinical high intensity focused ultrasound (HIFU) devices.
In the U. S., medical devices are regulated under the authority of the 1976 Medical Device Amendments to the Food, Drug, and Cosmetic Act, with the Food and Drug Administration's Center for Devices and Radiological Health having primary responsibility. The Act defines several regulatory paths to market depending on the complexity of the device and indications for use. ⋯ Pre-clinical testing generally comprises ultrasound power measurements and field characterization, in vitro and in vivo temperature measurements, thermal computational modeling, and demonstrating the accuracy for targeting the region of interest and monitoring treatment progress. Protocols for clinical trials are developed by the device sponsor in conjunction with FDA medical and scientific staff. Currently there are no recognized guidance or standards documents for HIFU testing that could be used in the regulatory review process, but such work is underway within the International Electrotechnical Commission.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
A wavelet based method for steady-state detection in anesthesia.
With the recent concern on patient's outcome following general anesthesia, automatic control of drugs has been a field of interest. The Bispectral Index (BIS) is an EEG based hypnosis monitor, in current use at the operating theatre as a guiding tool for the anesthesiologist to titrate drugs, and prevent awareness. ⋯ A steady-state index was obtained using a wavelet analysis technique for trend detection. This tool may be used in the future to model the drug's combined effect on the hypnosis indices, and also to bring some insight on disturbances not related to drug changes.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Randomized Controlled TrialEffect of remifentanil on the nonlinear electroencephalographic entropy parameters in propofol anesthesia.
Nonlinear electroencephalographic entropy parameters have been proposed for the assessment of depth of anesthesia. The influence of remifentanil, a commonly used intraoperative opioid, on these parameters, namely approximate entropy (ApEn), sample entropy (SampEn), and permutation entropy (PeEn), during induction of propofol anesthesia was studied. ⋯ No consistent influence on PeEn was observed. However, this may have been due to strong interindividual variation in PeEn values.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Validation of a graphic measurement of heart rate variability to assess analgesia/nociception balance during general anesthesia.
The optimization of analgesic drugs delivery during general anesthesia (GA) requires to evaluate the pain/analgesia balance. Heart Rate Variability (HRV) analysis has long been shown to measure the autonomic nervous system tone, which is strongly influenced by anesthetic drugs. ⋯ Measurements on simulated RR series showed that the graphic assessment is independent from respiratory rate, while LF and HF spectral measurements are over- and underestimated for respiratory rates lower than 12 cycles min Clinical measurements on 49 patients during GA showed that normalized HF power was strongly related to hemodynamic responsiveness during GA, and was strongly correlated with normalized EnvTOT measurements. A real time computation of the RR series could therefore help medical staff to anticipate hemodynamic responsiveness and the analgesia/nociception balance during GA.