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18-May-11
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When Medicine meetsWhen Medicine meets EngineeringEngineeringImproving safety in the operating room and beyondImproving safety in the operating room and beyond
Guy Dumont and
Departments of Electrical and Computer Engineering and Anesthesiology, Pharmacology & Therapeutics,
The University of British Columbia, Vancouver, Canada.
Mark Ansermino
Bertram Neville BrockhouseBertram Neville Brockhouse
1918 – 2003
1994 Nobel Prize in Physics
NSERC Prize for Interdisciplinary Research in Science and Engineering
Thank You
• NSERC for awarding us the 2010 Brockhouse Canada Prize
• NSERC and CIHR for supporting our work over the yearsUBC F l i f A li d S i d f • UBC Faculties of Applied Science and of Medicine
• Departments of Electrical & Computer Engineering and of Anesthesiology, Pharmacology & Therapeutics
Chronology• 1999: Initial contacts• 2000: Work in sensing and control starts• 2002: Peter Wall Institute of Advanced
Studies Exploratory Workshop on Automation and Robotics in the ORAutomation and Robotics in the OR
• 2002: GD-MA collaboration starts• 2003: Founding of ECEM
Funding via NSERC/CIHR CHRP Grants
• 2003-05: Online monitoring of physiological parameters
• 2005-07:Tactile display of physiological monitoring2008 10 Cl d l l f h i• 2008-10: Closed-loop control of anesthesia
• 2011-13:The phone oximeter
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Delivery of FastanII main backing store for the 418/III. Capacity 132MB. London Hospital 1970
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• Information overdose
• Limits to human vigilance
• Complexity
Change Matters ??Change Matters ??Detecting physiological trend changesDetecting physiological trend changes
Trend Detection
Meet IAN: The Intelligent Anesthesia Navigator Trend Detection
Patient-adapted change detection
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Trend Detection iAssist in the OR
Vibrotactile Display Vibrotactile Display
Vibrotactile Display
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Automation
Modern Anesthesia
The Anesthesia Process Closed-Loop Control of Intravenous Anesthesia
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Control of Neuromuscular Blockade Monitoring of Cortical Activity
Clinical Tests Monitoring of Nociception
• Pupillometry
SPI based on heart rate and plethysmograph• SPI based on heart rate and plethysmograph
• Heart rate variability (HF/LF)• Respiratory sinus arrhythmia (RSA)
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Portable Anesthesia Control System
Global Health The mHealth RevolutionThe mHealth Revolution
The Phone OximeterThe Phone Oximeter iPleth Block Diagram
NoninXpod
interfaceSensor
RR extractionPleth
RR
SpO2+HR
smartphone
Decision Support Engine
OpenGLEngine
User Input Interface
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Global Applications• In Burundi (pop 8M):
• Two anesthesiologists
• Thirty-four anesthesia nurses
• One closed-circuit anesthesia machine
The lung is a WINDOW to the body Infant Pneumonia (ALRI)Infant Pneumonia (ALRI)
Two million deaths a yearTwo million deaths a year
Why do they die?Why do they die?
No Treatment
Inappropriate treatment
Inadequate treatment
Infant Pneumonia
Simple Treatments!Simple Treatments!
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Neonatal Infection
One million a year dieOne million a year die
SpOSpO22 will change the world!will change the world!
ImpactEarly diagnosis (screening)
Lay health worker diagnosis
Follow response to antibioticsFollow response to antibiotics
Reduced antibiotic use
Early referral
Manage oxygen therapy
Technology for Healthy Living