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 2007
Real-time development of patient-specific alarm algorithms for critical care.
The state-of-the-art monitoring systems for critical care measure vital signs and generate alerts based on the logic of general patient population models, but they lack the capabilities of accurately correlating physiological data with clinical events and of adapting to individual patient's characteristics that do not fit the population models. This research examines the feasibility of developing patient-specific alarm algorithms in real time at the bedside and evaluates the potential of these algorithms in helping improve patient monitoring. Modular components that facilitate real-time development of alarm algorithms were added to a system that simultaneously collects physiological data and clinical annotations at the bedside. ⋯ The performance of patient-specific alarm algorithms improved as training data increased. Neural networks with eight hours of training data on average achieved a sensitivity of 0.96, a specificity of 0.99, a positive predictive value of 0.79, and an accuracy of 0.99; these figures were 0.84, 0.98, 0.72, and 0.98 respectively for the classification trees. These results suggest that real-time development of patient-specific alarm algorithms is feasible using machine learning techniques.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2007
Control of depth of anesthesia using MUSMAR--exploring electromyography and the analgesic dose as accessible disturbances.
The problem of controlling the level of depth of anesthesia measured by the Bispectral Index (BIS) of the electroencephalogram of patients under general anesthesia, is considered. It is assumed that the manipulated variable is the infusion rate of the hypnotic drug propofol, while the drug remifentanil is also administered for analgesia. ⋯ The performance of the controller is illustrated by means of simulation with 45 patient individual adjusted models, which incorporate the effect of the drugs interaction on BIS. This controller structure proved to be robust to the EMG and remifentanil disturbances, patient variability, changing reference values and noise.
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the continuous monitoring of splanchnic organ oxygen saturation (SpO2) would make the early detection of inadequate tissue oxygenation feasible, reducing the risk of hypoperfusion, severe ischemia, multiple organ failure, and, ultimately, death. In an attempt to create a splanchnic SpO2 sensor that can be used intra-operatively, pre-operatively and post-operatively this paper describes the design and technical evaluation of fiber optic based reflectance pulse oximeter sensor and processing system. In a detailed investigation to determine the optimal source-emitter spacing it was found that the optimum separation distance was between 3mm and 6mm. In vivo thermal testing showed that the rise in temperature at the tip of the fiber at both wavelengths was insignificant and therefore should have no effect in the splanchnic tissue.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2007
Local control of temperature in a theoretical human model of selective brain cooling.
A method of feedback control of local brain temperature during therapeutic intracarotid cold saline infusion is presented and tested on a theoretical cerebral heat transfer model based on the Pennes bioheat equation. In this temperature control method, the infusion rate of cold saline is varied based on the rate of temperature change, and the deviation of temperature to a target, within a voxel in the treated region of brain. ⋯ Two hours of treatment decreased the required inflow of ice-cold saline from 30 ml/min to 21 and 7 ml/min in the non-ice and ice cases, respectively. Intracarotid hematocrit had higher values in the non-ice case.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2007
Automatic identification of spike-wave events and non-convulsive seizures with a reduced set of electrodes.
Epileptiform activity in the brain, whether localized or generalized, constitutes an important category of abnormal electroencephalogram (EEG). Seizures are episodes of relatively brief disturbances of mental, motor or sensory activity caused by paroxysmal cerebral activity. They are not always accompanied by the characteristic convulsions that we commonly associate with the word epilepsy. ⋯ The proposed signal processing algorithm is based on the detection of spike-wave events obtained from a wavelet analysis of the EEG signal, combined with an analysis of the complexity of the EEG using fractal dimension estimates. We show that this algorithm has excellent sensitivity and specificity. In particular, the fractal analysis is a key factor in the removal of falsely detected spike-wave events (false positives) that can be caused by voluntary or involuntary artifacts such as fast eyelid flutter.