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机械通气患者连续代谢监测系统。

System for continuous metabolic monitoring of mechanically ventilated patients.

作者信息

Shaw Gary, Vicario Francesco, Buizza Roberto

机构信息

Lincoln Laboratory, Massachusetts Institute of Technology, Advanced EO Systems, Lexington, MA, United States.

Philips, Eindhoven, North Brabant, Netherlands.

出版信息

Front Med (Lausanne). 2024 Jul 2;11:1356087. doi: 10.3389/fmed.2024.1356087. eCollection 2024.

Abstract

In clinical settings, due largely to the cost, size and calibration complexity of existing indirect calorimetry systems, there is seldom instrumentation available to provide reliable, continuous tracking of a mechanically ventilated patient's metabolic output in support of proper nutrition. The atypical metabolisms associated with critically ill patients are difficult to predict and both underfeeding and overfeeding lead to negative impacts on both mortality and the recovery and healing processes. With these issues in mind, a novel ventilator-agnostic indirect calorimetry sensor design, prototype development, and validation were undertaken with the goal of enabling 24/7 metabolic monitoring of mechanically ventilated patients by means of a passive, rate-proportional side-stream sampling scheme and miniature mixing chamber. The miniature mixing chamber enables the use of small, low-cost gas concentration and flow sensing components to ensure the affordability of commercial design-for-manufacture implementations of the prototype sensor. In addition to continuous measurement of patient metabolism, the prototype sensor also enables autonomous monitoring and detection of calibration drift in the gas measurement sensors without disrupting the patient ventilation.

摘要

在临床环境中,主要由于现有间接量热法系统的成本、尺寸和校准复杂性,很少有仪器能够提供可靠的、连续跟踪机械通气患者的代谢输出,以支持适当的营养。与重症患者相关的非典型代谢难以预测,喂养不足和喂养过度都会对死亡率以及恢复和愈合过程产生负面影响。考虑到这些问题,我们进行了一种新型的与呼吸机无关的间接量热法传感器设计、原型开发和验证,目标是通过被动、速率成比例的旁流采样方案和微型混合室,实现对机械通气患者的全天候代谢监测。微型混合室能够使用小型、低成本的气体浓度和流量传感组件,以确保原型传感器在商业制造设计实施中的可承受性。除了连续测量患者的新陈代谢外,原型传感器还能够在不干扰患者通气的情况下,自主监测和检测气体测量传感器中的校准漂移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3187/11250480/cdbd547c3b6f/fmed-11-1356087-g001.jpg

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