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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