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MEDICAL (Anesthesia)

Background. Anesthesiologists face unexpected incidents during 20 percent of all anesthetics. One quarter of these incidents represent critical events posing significant danger to patients. Therefore, quick and accurate decisions are a major concern in anesthesia. The environment is stressful and the task is difficult because 30 or more variables need to be monitored and mentally correlated and integrated.

Technology. The CROMDI Medical team developed a working prototype for detecting, diagnosing and treating anesthesia-related critical events that reduces recognition times significantly in critical events. The CROMDI original display consisted of cardiac objects and pulmonary curtain and is shown in Fig. 1 alongside the traditional waveform displays (Fig. 2).

 
Figure 1. IntuInfo Anesthesiology application. The prototype shows 13 variables on a single screen in real time (Heart Rate: HR; Diastolic, Systolic and Mean Blood Pressures: DBP-SBP-MBP; Arterial
(click to view initial anesthesia design animation)
 
Figure 2. Traditional display showing the same information

CROMDI has produced additions and enhancements to the original display (consisting of cardiac objects and pulmonary curtain: a cardiovascular display, a pulmonary display, and a drug delivery and prediction display (Figures 3 and 4).
 

Figure 3 & 4. Pulmonary and Cardiovascular Displays. These integrated graphic displays are organized to show functional relationships between variables and to increase pattern recognition for disease states.
(click to view cardiovascular display animation)
 
Figure 5. Drug Display. This display is designed to aid the clinician in monitoring and predicting the concentrations and effects of drugs given during a surgery.

The new "integrated" display (Fig. 6) includes the waveforms and digital information present in traditional anesthesia displays, along with a selection of CROMDI's new display elements.

Figure 6. IntuInfo+ Anesthesiology application. This integrated display shows a combination of new visualization technology with traditional graphics to create a hybrid display
(click to view integrated display animation)

Testing. Testing of the prototype showed a statistically significant decrease in detection time in several critical scenarios:

  • Clinicians detected anesthesia-related critical events sooner (3.1 vs. 5.5 min)
  • Abnormal events were diagnosed more accurately (error rate 1.1% vs. 4.1%)
  • Problems were corrected in one-third the time (17 sec vs. 45 sec)
  • Drug delivery was better controlled (EC95 error 21% vs. 44%)

    Benefits. These are real world and economic benefits of the technology:

  • Enhanced vigilance and patient safety
  • Reduced diagnostic errors and liability
  • Correct treatment with fewer side effects
  • Faster wakeup and reduced drug cost