Poster
# 101
Poster |
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6th Internet World Congress for Biomedical Sciences |
Jose Luis Ruiz Gonzalez(1), Francisco Taboada(2), Antonio M. López(3), Alberto Diez(4)
(1)Universidad de Oviedo - Oviedo. Spain
(2)Hospital Central de Asturias - Oviedo. Spain
(3)(4)University of Oviedo - Gijón. Spain
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[Medical Electronics & Engineering] |
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[New Technology] |
Worldwide economical crisis and progressive reduction of available beds in hospitals has forced Intensive Care Units to improve the functions and efficiency of their activities. These changes need the improvement of two interrelated areas: technological development with high cost-effectiveness relation and information systems that allow a more efficient use of technology.
The demands to which Intensive Medicine is faced up are the result of a particularly difficult dichotomy in modern medicine. While there are more means available to treat critical patients each time, financial resources which support the advanced care of these patients are being progressively limited due to economical a budget reasons.
It is in this context that we have posed the simultaneous integration of several monitoring systems on a critical patient that can bring maximum effectivity with minimal risks, and which can contribute to future advances in our capability to treat patients that are referred to the Intensive Medicine Unit. To sum up, we try to combine emergent technologies with tools for database usage.
Critical patients who are referred to a Critical Care Unit often have a deficit in tisular perfusion and an initial compensating response characterized by vasoconstriction, independently that the initial cause was a consequence of hipovolemia, trauma, low output syndrome, or something else. In any of these situations the inadequate tisular perfusion can lead to tisular hipoxia, bad micro-circulation distribution, reperfusion damage, multiorganic failure and death.
Even though the clinical picture of shock is easily diagnosed when it is established, it is much more difficult to recognize in its initial stages when the symptoms are imprecise. This means important delays in its treatment and, as a consequence, worse results. If early monitoring and diagnose can be achieved by a simultaneous combination of different systems, then tisular hipoperfusion situations can be early solved and thus survival can increase.
The main goal of this study is the establishment of a is the development of a method of multiple monitoring, both bloody and bloodless, which allows an early diagnosis and an aggressive treatment from the beginning in hipoperfusion situations. Previous studies have shown that optimizing oxygen delivery preoperatively and keeping it in supra-normal values during postoperative reduced mortality by 75%. In contrast with these results, other studies showed that there wasn´t any improvement in patients referred to an ICU after developing a multiorganic failure, in spite of the therapeutic efforts made.
Thus, our work has been pointed towards the implementation of major components of circulation inside a program that allowed capture and storage of physiological signals by a computer. These major components include variables that inform of haemodynamics, respiratory situation and oxygen carriage and consumption.
Cardiac output is calculated using TFI (thoracic fluid index) and the outline of a pulse wave. Systolic, diastolic and mean arterial pressures through an arterial catheter and a pressure monitor.
TFI method uses a tetra-polar electrode system, which are located in the neck and thorax of the patient, and through which alternative current of 4 mA at 100 KHz goes. This allows a signal of ECG and the first derivative of the impedance, which is afterwards processed to obtain heart rate, cardiac output and stroke volume.
Through the pulse wave method, which requires inserting a catheter into the femoral artery, cardiac output can also be obtained, in addition to intra-arterial pressures. That method requires a pre-calibration through by getting the cardiac output through transpulmonary thermodilution. The monitor also informs of the state of myocardial contractility through the derivative pressure/time.
To get the transcutaneous oxygen saturation, a conventional pulsioximeter is used.
Oxygen consumption is studied through indirect calorimetry. The same device informs of CO2 production. El O2 is carriage is deducted once cardiac output, hemoglobin and O2 saturation are known.
Pressure, flux and volume signals are obtained through respirators, if the patient is being subjected to mechanical ventilation
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[Medical Electronics & Engineering] |
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[New Technology] |
