Transcript Intensive Care Window Real time monitoring and analysis in the Nikolas Stylianides

Intensive Care Window
Real time monitoring and analysis in the
Intensive Care environment
Nikolas Stylianides
Marios Dikaiakos
George Panayi
Theodoros Kyprianou
11/10/09
[email protected]
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Introduction
• Intensive Care Units (ICUs) treat patients
that are in a critical (life-threatening)
physiological state.
• More than 4.000.000 people are admitted
each year in ICUs in the U.S. alone –
500.000 of them do not survive. (The Leapfrog group,
2000)
– 12%
11/10/09
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Motivation
• Human factor (on call ICU nurse) still is
the invaluable tool in the ICU setting.
• Clinical systems commercially available
utilize proprietary code and interface
protocols.
• High cost to purchase, deploy and
manage commercially systems.
11/10/09
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3
Challenges
• A plethora of medical devices are used in the
ICU to monitor the patients.
• The vast majority of medical device vendors
utilize proprietary communication interfaces and
languages to export information.
• Large volumes of produced data (physiological
parameters, vital signs, medical images) that
hospitals infrastructures cannot store for large
periods of time.
• Personal and sensitive data.
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4
Intensive Care Unit
Monitor Device
Ventilator
Drug infusion–administration
pumps
Portable Devices
Laboratory Information
Systems
Numerous other medical
devices, diagnostic
equipment, …
11/10/09
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Medical Record Information
Radiology
Hospital
Pharmacy
Knowledge
Bases
Physiological
Monitors
DICOM &
HL7
HL7
HL7
HL7
HL7
HL7
PMRI
IEEE 1073
ISO 11073
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IEEE 1073
ISO 11073
Billing
Clinical
Content
HL7
IEEE
Medical
Devices
Patient
Registration/
Admissions
Laboratories
Orders &
Results
Bedside
Computer
[email protected]
Payers
ASC
X12N
NCPDP Retail
ASC X12N
Pharmacy
Benefits Mgrs
NCPDP Retail
X12N
Retail
Pharmacies
NCPDP script
Provider
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ICW System
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ICW bedside controller
• Automatic & semi
automatic medical
device configuration
• Standard compliant
communication paths
• Hides proprietary
protocol complexity
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8
ICW major contributions
Real time monitoring and supervision
Data collection annotation
Local search capability
Playback functionality
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ICW visual tools
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Real life scenarios deployment
SCENARIO A:
Multiple Organ Dysfunction Syndrome
Mean blood pressure
Blood glucose
SaO2 - Oxygen Saturation
SCENARIO B:
Traumatic Brain Injury
Cerebral perfusion pressure
Blood glucose
SjO2 - Jugular Bulb Oxygen Saturation
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Scenario Statistics
• Philips MP70
– Arterial blood pressure
diastolic, Arterial mean
blood pressure, Arterial
blood pressure systolic,
… (in total 14
parameters)
• Puritan Bennett
Ventilator 840
– Exhaled minute volume,
Exhaled tidal volume, ..
(in total 18 parameters)
• 3 Months period
• 10 Patients
• 2 ICW bedside
settings
• 2 ICW system users
• 72 hours average
session duration
• 0,5 MB average
information stored per
hour per patient
• ABL 800 Flex
– Jugular bulb oxygen
saturation (SjO2), blood
glucose
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12
Near future work
• Full scale deployment for longer period of time.
– This will rise new needs and feature requests
• Initiate an open source project.
• Enhance local search functionality.
• Introduce ICU scoring functionality (Acute Physiology and Chronic
Health Evaluation , Simplified Acute Physiology Score, …).
• Extend the medical device driver library.
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13
Thank you for your
Attention
Questions ?
11/10/09
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