Computing and Monitoring in Anesthesia and Intensive Care: Recent Technological Advances

494 Pages·1992·25.32 MB·English

by  James H. Philip M.E.(E.)

K. Ikeda· M. Doi· T. Kazama
K. Sato· T. Oyama (Eds.)
Computing and
Monitoring in Anesthesia
and Intensive Care
Recent Technological Advances
With 254 Figures
Springer-Verlag
Tokyo Berlin Heidelberg
New York London Paris
Hong Kong Barcelona
Budapest
KAZUYUKI IKEDA, M.D., Professor and Chairman
Department of Anesthesiology and Critical Care Medicine,
Hamamatsu University School of Medicine, Japan
MATSUYUKI DOl, M.D., Assistant Professor
Department of Anesthesiology and Critical Care Medicine,
Hamamatsu University School of Medicine, Japan
TOMIEIKAZAMA, M.D., Associate Professor
Department of Anesthesiology and Critical Care Medicine,
Hamamatsu University School of Medicine, Japan
KAzuo SATO, M.D., Associate Professor
Department of Anesthesiology and Critical Care Medicine,
Hamamatsu University School of Medicine, Japan
TSUTOMU OYAMA, M.D., Emeritus Professor
Department of Anesthesiology, Hirosaki University, Japan
ISBN-13: 978-4-431-68203-5 e-ISBN-13: 978-4-431-68201-1
DOl: 10.1007/978-4-431-68201-1
© Springer-Verlag Tokyo 1992
Softcover reprint of the hardcover 1st edition 1992
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Preface
In April of 1991, 425 partICIpants from 18 countries met in
Hamamatsu in Japan for the 6th International Symposium on Computing
in Anesthesia and Intensive Care (lSCAIC). The meeting was one of the
most spectacular academic and fruitful in the history of ISCAIC.
We had four days of fascinating presentations and discussions
covering many areas of technology in Anesthesia and intensive care.
New technologies were presented and old technology reexamined.
The measures of success of the meeting were the excellent research
material in oral and poster presentations, and state of the art reviews of
the latest issues by distinguished worldwide key speakers.
It must be sure that the meeting was most effective to promote and
disseminate up-to-date information in these fields across the
participating countries.
The aim of this book is to record the exciting achievements of the
meeting and extend them further among our colleagues. We hope the
readers of this book will share the same excitation as well as the latest
information in this speciality.
Finally we would like to extend our deepest gratitude to all
participants and others for the contribution to the compilation of this
book.
Kazuyuki Ikeda, M.D.
Chairman of the organizing committee
of the 6th IS CAlC
Editor in Chief
Contents
Patient Safety: Minimum Requirements
and Advanced Techniques in Monitoring
Minimum Monitoring Requirements (USA)
James H. Philip ................................•....•.•........• 3
Oxygen Monitoring in Respiratory Gas
Markku Paloheimo ...............•.••....•.....•.•....•.•••..... 7
Anesthetic Gas Monitoring
James H. Philip . . • . . . . . . . . . . . . . . . • . . . . . . . . . . . • • . . . . . . . • . . . . • . .• 1 4
Intraoperati ve Echocardiography
Patrick E. Curling .........•.••....•..•..........•.....••....... 20
CNS Monitoring
N. Ty Smith, Ira J. Rampil 22
Patient Monitoring - The European View
J. F. Crul ..............•.......................•...•.•.•...••. 2 3
Artificial Intelligence
Artificial Neural Networks in Medical Monitoring:
A Primer for Physicians
Julian M. Goldman, Bruce H. Dietrich 27
The Use of Model and Artificial Intelligence Techniques in Patient
Monitoring
Yojiro Sakiyama, Naonobu Sukegawa, Masao Saito, Masayuki Suzukawa,
Masakazu Tsuzuki ..................•.........•...........•..•.. 33
Expert System
A Computational Architecture Using Procedural Reasoning for
Decision Support in Anesthesiology
John Zelcer, Michael P. GeirgefJ, Magnus Ljungberg 37
Critical Care Decision Support Systems
Thomas D. East, Alan H. Morris, C. Jane Wallace, Lindell K. Weaver,
Terry P. Clemmer, James F. Orme, Susan E. Henderson ...........•...... 3 8
Contents
Intelligent Alarm System for Anesthesia (IASA)
P. H. Pan, J. J. van der Aa ........•..•......................•....• 40
A Knowledge Based Alarmer for the Postoperative Care of Cardiac
Patients
Erkki M. J. Koski, Tommi Sukuvaara, Aki Miikivirta, Aarno Kari 42
Medical Expert Systems with Physiological Models for
Hemodynamical Monitoring
Hiroshi Yochi, Masao Saito ....................•....•............. 45
Information Interpretation in a Real-Time Knowledge-Based
Respiratory Monitoring System
Aiping Jiang, Paul King, Bradley Smith .............•.........•..... 47
Computer Assisted Diagnostic Procedures in the Pain Clinic Using an
Expert System
Mikio Takeuchi, Yasunori Hanamura, Nobuyuki Tanaka, Takako Tsuda,
Hirotada Katsuya ................•.........•.•......••......... 5 0
Simulation and Modeling
ASC: Educational Anesthesia Simulator with Expert System
Howard A. Schwid, Daniel O'Donnell .......•........................ 5 5
Digital Computer Simulation of Cardiovascular System in Bleeding
Patient for Clinical Management
Yasuhiro Fukui, Toru Masuzawa, Makoto Ozaki, N. Ty Smith 64
Gas Man Simulates Correct Alveolar Plateaus and Quantifies
Overpressure for Desired Alveolar Tension
James H. Philip .............................•.......•.......... 7 3
Real Time Joint of Pharmacokinetic Simulation and Monitoring in
Inhalational Agents
Yoshimitsu Sanjo, Kazuyuki Ikeda 78
A 24-Hour Prediction Model of Blood Pressure Employing Endocrine
System and Autonomic Nervous System
Toshihiro Nishimura, Masao Saito ................................. 84
A Simulation Analysis for Optimal Plasma Potassium Concentration
during Cardiopulmonary Extracorporeal Bypass
Yoshifumi Tanaka, Miho Nakagawa, Satoru Hashimoto, Eiichi Chihara,
Takashi Kinoshita, Munetaka Hirose ................................ 93
VIII
Contents
Eucapnic Hyperpnea Facilitates Recovery from Inhalational
Anesthesia
Damon C. Sutton, Ignatius D. Calalang, Daniel B. Raemer, James H. Philip .... 97
Anaesthetic Agent Uptake and Distribution
J. Alastair Lack .......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1 00
A Theoretical Analysis of Optimal Control of Cardiovascular System
H. Hirayama, T. Nishimura, K. Ono ..................•............. 1 0 1
Education
A Revised Computer Program for Respiratory Care and Blood Gases
Kohei Yamashita, Kunio Suwa ......•.....•....•................. 107
Use of Pharmacologic Models for Teaching Anesthesiology Residents
Thomas S. Scanlon ..................••..•.........•........... 1 09
Automated Control
Computer Controlled Infusion Systems
Gavin N. C. Kenny ............................................ 1 1 3
Computer Controlled Continuous Infusion
F. Engbers; J. Bovill ........................................... 1 1 7
A Computer-Aided Controller of Fluid Infusion Rate in Post
Operative Management of Open Heart Surgery
Tsuyoshi Kawamura, Kyouichi Ogawa, Yasuhiro Fukui, Takanori Sakamaki .. 120
Computer Aided Patient (CAP) Care System
~ Takanori Sakamaki, Yasuhiro Fukui, Tsuyoshi Kawamura, Hajime Yasuda... 122
Fluid Control Based on Fuzzy Control Algorithm
Yasuhiro Fukui, Tsuyoshi Kawamura, Takanori Sakamaki 124
A Simulation and a Control System of Neuromuscular Blockade
Koji Morita, Kazuyuki Ikeda ..................................... 1 27
Evaluation of a Computer Aided Propofol Infusion System
Martin White, Gavin N. C. Kenny ............................••... 130
Computerised Alfentanil Infusion in Postoperative Analgesia
Gavin N. C. Kenny, F. W. Davies, Martin White ....................... 1 34
IX
Contents
Assessment of the Value of Computerized Propofol Infusion
Gavin N. C. Kenny. lain Taylor. Martin White .•.....•....••........•• 137
Development of a Computer Controlled Infusion System
Gavin N. C. Kenny. Martyn Gray. Martin White 139
Isocapnic Clamping with Feedback and Feed-Forward Control
J. R. Sneyd. D. M. Band ...............•............••.......•... 1 42
The Intelligent Control System of Physiological System Regulation
Toru Masuzawa. Yasuhiro Fukui •....••.•.........••........•.... 144
Performance Evaluation of a Closed-Loop Sodium Nitroprusside
Delivery Device during Hypotensive Anesthesia in Mongrel Dogs
N. Ty Smith. James F. Martin. Michael L. Quinn. Tom S. Scanlon.
Gregory I. Voss •••.....•.•.••••....•...••......••..........••.. 147
Adaptive Control of Arterial Pressure:
A Supervisor can Improve Safety and Efficacy
James F. Martin. N. Ty Smith. Michael L. Quinn. Tohl Masuzawa.
Jeff E. Mandel ................•..........•.....•.............• 150
A Computer Control System of Applying Anesthesia Using Fuzzy
Logic for Medical Operation (Categorization of anaesthesiologists
thinking represented by artificial intelligence and comparison of
each category)
Tomoa/cj Imamura, Tadaki Horiuchi. Heizi Okuda. Morio Uchida .•.••.•..• 153
Automatic Adjustment of Minute Volume by Carbon Dioxide
Excretion with Servocontrol System
Osamu Yamaguchi. Yutaka Usuda. Kazuhiro Kaneko. Masahide Ohtsuka.
Fukuichiro Okumura ...........•....•••••..•....••............• 1 56
Patient Data Management System
Patient Data Management
Wolfgang Friesdorf. Bernhard Schwilk 161
Anesthesia Records, Displays, and Alarms
Allen K. Ream •....................•............... . . . . . . . . . .. 1 7 1
PDP System/PC an Efficient Combination for Data Management in
the Intensive Care Unit
Sergio Konichezky. Eli Mandel. David Kutas. Smadar Shapira. Jan De Hooge 1 76
Data Management in the Operating Room and Intensive Care
Ulrich Bonnaire ..........••.......•••.......•••.••••......••• 1 78
x
Contents
Computerized Monitoring and Recording System in Anesthesia and
Intensive Care Medicine Using an Engineering Work Station
Katsuyuki Katayama, Norihiko Sakuraya, Osamu Kemmotsu ............. 180
Computerized Intraoperative Monitoring System at Montefiore
University Hospital
Kazuo Oishi, Miroslav Klain, Antonio Porreca, Joseph Goode, Jr.,
Renee Molner, William Tullock, Robert Sclabassi ...................... 1 83
Microcomputer Management of Anesthetized Patients' Information
Nai-Feng Deng, Ke-Mei Shi, Jian Hao .............................. 1 85
Laboratory Data Management in Our ICU
Michio Yoshinari, Atsushi Kaise, Yasuhiko Hashimoto ......... ;....... 187
A Computerized Graphic Monitoring System for the Management of
Open Heart Surgery
Toshihiko Satone, Shouichi Takado, Yusuke Ito, Mitsuo Yoshimoto ........ 189
The Anesthesia Information Console: An Integrated Information
System for Anesthetic Care
Osamu Uchida, Masakazu Kuro ................................... 1 90
Perioperative Data Management System - An Initial Report on the
Intraoperative Patient Data Management System
Shosuke Takahashi ............................................ 1 9 3
Automated Analog and Digital Data Logging System in Intensive
Care Unit
Satoru Hashimoto, Teiji Sawa, Eiichi Chihara, Takashi Natsuyama,
Yoshi!umi Tanaka ............................................ 1 96
Clinical Process Models for Intensive Care
• Miikeliiinen Annikki, llomiiki Arja, Karp Pekka, Kalli Seppo 199
Ohmeda Arkive 1 Patient Information Management System
- An Operating Room Based Database Analysis Network
Douglas Brown ............................................... 20 1
Network
LAN in the Automatic Collection of Postoperative Monitoring Data
Erkki M. J. Koski, Matti A. K. Mattila, Mikko Eloranta .................. 205
Multiple Media for Monitoring Respired Air during Anesthesia
Junya Sakai, Mitsuru Ohyama 207
XI
Contents
On-Line Data Integration System in Kanazawa Medical University
Hospital
Koichiro Nakamura, Hidemaro Mori, Hiroshi Chikuda 211
Intraoperative Transmission of Digital Data Using Intelligent Radio
Modems
Takuya Ikeda, Takahiko Mori, Toshihiro Kawai 213
Use of an Inter-Bed Local Area Network System in Operating Room
Yutaka Sato, Noriyuki Amano, Akitomo Matsuki ...................... 215
A System of Computer Integration of Patient Monitors in Operating
Rooms
Toyoki Kugimiya, Masakazu Tsuzuki, Katsuo Numata 217
Development of Operation System
Seiji Kato, Yasuharu Kitani, Tatushi Fujita 220
On-line Multi-Channel Audio-Video Signal Transmission by Optical
Fiber. and its Clinical Use
K. Morita, K. Ikeda, J. Z. Li, H. Ikeda, H. Yoshida, S. Shinohara, E. Tsuchiya,
K. Nishimura ................................................. 222
Wireless Data Communication: Example of an Application for the
Operating Room
Frederic deBros, Eiichi Inada .................................... 225
Remote Monitoring of Home Ventilation Through the Personal
Paging System
Yoichi Kondo, Katsuyuki Miyasaka, Takashi Isoyama, Hideo Nakazawa ..... 227
Data Base
Anesthetic Concerns in Uncommon Diseases - A New Database
S. Cohn, E. Toyooka, N. Sidell, C. Beaver ............................. 23 1
Data-Base in Our Department Using REXAS as a Sort of LAN
Hidemaro Mori, Koichiro Nakamura, Tomio Matuda, Hiroshi Chikuda 233
An Application of the Optical Drive System for Keeping Anesthesia
Records
Masatoshi Muraoka, Yutaka Satoh, Hironori Ishihara, Akitomo Matsuki 236
An Ultrafiche Storage of Anesthesia Case, Computer Display and
Search by a Scanner
Weiben Yuan, Nai-Feng Deng. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 237
XII