Division of Cardiac Surgery, Medical Robotics and Computer Assisted Surgery Lab, VA Boston Healthcare System, West Roxbury, MA 02132, USA.
Department of Surgery, Harvard Medical School, Boston, MA 02115, USA.
Sensors (Basel). 2020 Nov 19;20(22):6616. doi: 10.3390/s20226616.
Monitoring healthcare providers' cognitive workload during surgical procedures can provide insight into the dynamic changes of mental states that may affect patient clinical outcomes. The role of cognitive factors influencing both technical and non-technical skill are increasingly being recognized, especially as the opportunities to unobtrusively collect accurate and sensitive data are improving. Applying sensors to capture these data in a complex real-world setting such as the cardiac surgery operating room, however, is accompanied by myriad social, physical, and procedural constraints. The goal of this study was to investigate the feasibility of overcoming logistical barriers in order to effectively collect multi-modal psychophysiological inputs via heart rate (HR) and near-infrared spectroscopy (NIRS) acquisition in the real-world setting of the operating room. The surgeon was outfitted with HR and NIRS sensors during aortic valve surgery, and validation analysis was performed to detect the influence of intra-operative events on cardiovascular and prefrontal cortex changes. Signals collected were significantly correlated and noted intra-operative events and subjective self-reports coincided with observable correlations among cardiovascular and cerebral activity across surgical phases. The primary novelty and contribution of this work is in demonstrating the feasibility of collecting continuous sensor data from a surgical team member in a real-world setting.
监测医疗保健提供者在手术过程中的认知工作量，可以深入了解可能影响患者临床结果的心理状态的动态变化。认知因素对技术和非技术技能的影响作用越来越受到重视，尤其是在能够非侵入式地收集准确和敏感数据的机会不断增加的情况下。然而，在心脏手术手术室等复杂的真实环境中应用传感器来捕获这些数据，会受到无数社会、物理和程序上的限制。本研究的目的是调查克服后勤障碍的可行性，以便通过在手术室的真实环境中进行心率（HR）和近红外光谱（NIRS）采集，有效地收集多模式心理生理输入。在主动脉瓣手术期间，为外科医生配备了 HR 和 NIRS 传感器，并进行了验证分析，以检测术中事件对心血管和前额叶皮层变化的影响。所采集的信号具有显著相关性，并记录了术中事件和主观自我报告，与手术各阶段心血管和大脑活动之间的可观察相关性相吻合。这项工作的主要新颖性和贡献在于证明了在真实环境中从手术团队成员连续收集传感器数据的可行性。
