Anesthesia support systems.
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Anesthesiology↗
Biomedical subjects
S Meiyappan
Publications and source records attributed to S Meiyappan.
Real-time respiratory monitoring workstation--software and hardware engineering aspects.
We have applied advanced real-time techniques in software, that are intensively used in critical areas like space research and defence applications, to realise an Integrated Real-Time Respiratory Monitoring System at the Thorax Anesthesiology, Academic Hospital Rotterdam. The system is called the 'SERVO WINDOW'--a window to the servo ventilator. The heart of the system is a real-time kernel that uses preemptive scheduling to achieve multitasking on a IBM PC compatible hardware platform. To the clinician this means that he gets all relevant information from one source i.e. the Respiratory Workstation. The waveforms of the airway pressure, airway flow and the expired CO2 curve are displayed continuously on the screen. The Vector Loops like Pressure Volume, Flow Pressure and Flow Volume loops are also available in addition to the lung mechanics parameters like Expiratory and Inspiratory Resistances, Compliances, Peak Pressure, PEEP, etc. The Single Breath Diagram i.e. expired CO2 concentration versus volume and dead space ventilation is also calculated. The blood gas analysis data is plotted in convenient diagrams like the O2-CO2 diagram, Oxygen Chart, etc. The trend of all these parameters are available with a granularity of one minute. An industry standard laser printer is used for report generation to produce reports of the real-time waveforms, parameter values and the trends. User interface is through easy menus with the traditional keyboard, touchscreen including keyboard on screen for data entry and the mouse.
Computer Systems↗
Development of software for pulse oximeter and investigation of its realtime response in clinical environment.
We developed a pulse oximeter software at Thorax Centre, Erasmus University as a joint project with an industry and evaluated it in the clinical environment of thorax anaesthesia using a computerized protocol for realtime data collection during routine clinical procedures. This paper gives an account of the results we obtained from the development project and the clinical study. The paper consists of two parts. First part describes different components of the software module and their influence on different aspects of the clinical behaviour of the oximeter. The second part describes the results of realtime response investigation. The investigation was carried out using a personal computer to collect the data continuously during anaesthesia, surgery and post-operative periods. Two other industry standard oximeters, Nellcor and Ohmeda were also included in our study. We collected data on more than fifty patients on an average of eight hours per patient over a period of four months with major emphasis on low-saturation occurrences. The interpretation of the data was focused more on the realtime response anomalies on random cases than on ensemble statistical data evaluation. We found, that there are few factors in clinical environment which often influences the measurement of a pulse oximeter very strongly. Most often the anomalies were found during low saturation measurement. The main objective of this paper is to make the results available to practising clinicians so that it may be useful to identify these occurrences during routine clinical usage.
Evaluation Studies as Topic↗
A new approach: reusable real-time database for medical instrumentation applications.
Medical instrumentation (MI) software development work differs from other software development works mainly in the testing and validation phase. For MI software, this phase has always been most difficult, time-consuming and yet the most doubted phase. The primary reason being the input to these programs (ie) the physiological signals like ECG, pulse, etc. To be more specific, the problem is because 1. These physiological signal patterns vary so widely from person to person and hence these programs have to be validated statistically on all categories of persons including those on the extreme ends. 2. There are also artifacts riding on these signals (inherent, intentional or due to inevitable physical movements) 3. These signals are real-time ones to the order of a second. Above all, 4. They are not reproducible patterns, if you need them for study and analysis at a later date. Though it is tough to find alternatives for the present technique of statistical validation, there can be ways to make use of this time-consuming validation process to its fullest potential. One such way is to make a kind of 'CAPTURE-RETAIN AND REUSE' databases that can reduce the future efforts in the validation phase substantially. The main areas where these databases can make vital contributions are: 1. Medical Instrumentation software testing and validation 2. Medical Instruments' results and performance comparison 3. Expert system building, testing and enhancement of its capabilities.
Evaluation Studies as Topic↗