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 2006
ReviewIntegrating data, models, and reasoning in critical care.
Modern intensive care units (ICUs) employ an impressive array of technologically sophisticated instrumentation to provide detailed measurements of the pathophysiological state of each patient. Providing life support in the ICU is becoming an increasingly complex task, however, because of the growing volume of relevant data from clinical observations, bedside monitors, mechanical ventilators, and a wide variety of laboratory tests and imaging studies. ⋯ There is a critical need to integrate the disparate clinical information into a single, rational framework and to provide the clinician with hypothesis-driven displays that succinctly summarize a patient's trajectory over time. In this paper, we present our recent efforts towards the development of such an advanced patient monitoring system that aims to improve the efficiency, accuracy, and timeliness of clinical decision making in intensive care.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2006
High rate shear insult delivered to cortical neurons produces heterogeneous membrane permeability alterations.
Traumatic brain injury (TBI) occurs when brain tissue is subjected to stresses and strains at high rates and magnitudes, yet the mechanisms of injury and cellular thresholds are not well understood. The events that occur at the time of and immediately after an insult are hypothesized to initiate cell dysfunction or death following a critical cell strain and strain rate. We analyzed neuronal plasma membrane disruption in two in vitro injury models-fluid shear stress delivered to planar cultures and shear strain induction of 3-D neural cultures. ⋯ Furthermore, increased membrane permeability led to increases in electrophysiological disturbance. Specifically, cells that exhibited increased membrane permeability did not fire random action potentials, in contrast to neighboring cells that had intact plasma membranes. This approach provides an experimental framework to investigate injury tolerance criteria as well as mechanistically driven therapeutic strategies.
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Capnography, the monitoring of expired carbon dioxide (CO2) has been employed clinically as a non-invasive measure for the adequacy of ventilation of the alveoli of the lung. In combination with air flow measurements, the capnogram can be used to estimate the partial pressure of CO2 in the alveolar sacs. In addition, physiologically relevant parameters, such as the extent of CO2 rebreathing, the airway dead space, and the metabolic CO2 production can be predicted. ⋯ In addition, this allowed for a dynamic prediction of the unmeasured alveolar CO2 tension. The method is demonstrated using simulations of the capnogram. The proposed method could aid the clinician in the interpretation of the capnogram.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2006
A next generation electronic triage to aid mass casualty emergency medical response.
For years, emergency medical response communities have relied upon paper triage tags, clipboards of notes, and voice communications to share information during medical emergencies. This workflow, however, has proven labor intensive, time consuming, and prone to human error [1]. In collaboration with three EMS groups in the Washington, DC Metropolitan area, we have developed a next generation triage system to improve the effectiveness of emergency response. ⋯ Our system has evolved through three iterations of rapid-development, field-studies, usability reviews, and focus-group interview. This paper summarizes engineering considerations for technologies that must operate under constraints of medical emergencies. It is our hope that the lessons reported in this paper will help technologists in developing future emergency response systems.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2006
Development and implementation of a biomedical information network.
Once the requirement for a biomedical information network has been articulated, the process of development and implementation can then be approached. Although the general architecture of such a system may appear to be self evident, there are careful design considerations that will allow the network to be robust and achieve increased levels of functionality as additional systems come on-line and become integrated into the network. ⋯ We have chosen the Emergin Orchestrator product (Boca Raton, Fl) as the vehicle for integrating these systems. The major design and implementation tasks include defining the basic information architecture, assessing the performance of the existing IT infrastructure, and understanding the native capabilities and limitations of each system involved in the network.