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
Target controlled infusion for kids: trials and simulations.
Target controlled infusion (TCI) for Kids is a computer controlled system designed to administer propofol for general anesthesia. A controller establishes infusion rates required to achieve a specified concentration at the drug's effect site (C(e)) by implementing a continuously updated pharmacokinetic-pharmacodymanic model. This manuscript provides an overview of the system's design, preclinical tests, and a clinical pilot study. ⋯ Predicted C(e) values during standard clinical practice, the accuracy of wake-up times predicted by the system, and potential correlations between patient wake-up times, C(e), and state entropy (SE) were assessed. Neither Ce nor SE was a reliable predictor of wake-up time in children, but the small sample size of this study does not fully accommodate the noted variation in children's response to propofol. A C(e) value of 1.9 mug/ml was found to best predict emergence from anesthesia in children.
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Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) contribute to the morbidity and mortality of intensive care patients worldwide, and have large associated human and financial costs. We identified a reference data set of 624 mechanically-ventilated patients in the MIMIC-II intensive care database with and without low PaO(2)/FiO(2) ratios (termed respiratory instability), and developed prediction algorithms for distinguishing these patients prior to the critical event. In the end, we had four rule sets using mean airway pressure, plateau pressure, total respiratory rate and oxygen saturation (SpO(2)), where the specificity/sensitivity rates were either 80%/60% or 90%/50%.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2008
Predict the neurological recovery under hypothermia after cardiac arrest using C0 complexity measure of EEG signals.
Clinical trials have proven the efficacy of therapeutic hypothermia in improving the functional outcome after cardiac arrest (CA) compared with the normothermic controls. Experimental researches also demonstrated quantitative electroencephalogram (qEEG) analysis was associated with the long-term outcome of the therapeutic hypothermia in brain injury. Nevertheless, qEEG has not been able to provide a prediction earlier than 6h after the return of spontaneous circulation (ROSC). ⋯ Significantly greater C0 complexity was found in hypothermic group than that in normothermic group as early as 4h after the ROSC (P0.05). C0 complexity at 4h correlated well with the 72h neurodeficit score (NDS) (Pearson's correlation = 0.882). The results showed that the C0 complexity could be an early predictor of the long-term neurological recovery from cardiac arrest.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2008
Preliminary study on physiological changes of hemorrhagic shock in rats.
Hemorrhagic shock is a common cause of death in emergency rooms. The objective evaluation of hemorrhagic shock is very important for early diagnosis and treatment. ⋯ We constructed an integrated system to be able to control bleeding and to simultaneously measure bio-signals such as ECG, blood pressure, temperature, and respiration. In order to verify the system, we measured the bio-signals mentioned above while hemorrhagic shock was induced by withdrawing blood (2.5 ml / 100 g / 15 min) from a femoral vein for 10 rats.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2008
Clinical TrialValidation of the Index of Consciousness (IoC) during sedation/analgesia for ultrasonographic endoscopy.
The level of consciousness of patients undergoing surgery evolves continuously as the effect of the anesthetic agents is counteracted by the surgical stimuli. The monitors of depth of anesthesia, based on the analysis of the electroencephalogram (EEG), have been progressively introduced into the daily practice to provide additional information about the state of the patient. ⋯ A good correlation is found between both indexes. Furthermore, IoC presents a significantly higher prediction probability Pk of the level of sedation than BIS, and can thus be considered as an interesting measure of the level of consciousness.