ITBM-RBM最新文献

Cardio-pulmonary assistance is now possible outside a cardiac surgery unit, thanks to the last device generation. Four cases of assistance are reported, two for ARDS and two for intoxication with membrane stabilizer anti arrhythmic. In all cases, the evolution was good.

The 2007 hospital plan increases the number of modernisation projects in health establishments. One of the goals of those projects is to reduce the working costs. It can be done by grouping together similar technical departments. Édouard-Herriot Hospital is a good example of this phenomenon. Indeed, its scattered architecture will be abandoned for the project of new hospital planed for 2013. Within the framework of a project of a new hospital, the first stage consists to well define the functional courses, the capacity, specifications and a financial valuation of the new buildings, before the architectural project. During this first stage, the biomedical department was asked to elaborate an equipment program in order to foresee the financial amount of medical devices purchases which must be planned. First, we develop a general method for the elaboration and financial valuation of an equipment program. This procedure is based on the use of a software called “Key Data”. This software is used by the “hospices civils de Lyon” to establish their equipment programs. Secondly, this method is applied to the new critical care unit.

Objective

Air leakage is a major problem in long-term assisted ventilation both invasive and non-invasive that becomes even more important during sleep. The objective of this work was to provide a method for continuous estimation of tidal volume changes in patients under ventilatory support during sleep.

Materials and methods

Recordings were from 14 patients with neuromuscular disorders admitted to hospital for a routine evaluation of assisted ventilation during sleep. Air leakage was continuously evaluated from: 1) the difference between the insufflated and expired volume using a flow meter; 2) the changes in lung volume using inductance plethysmography.

Results

Both methods showed presence of air leaks in all patients and also variations in their amount throughout the night. However, inductance plethysmography provided more rigorous measurement of air leaks than flow meters as it measures the amount of air actually entering the lungs. The magnitude of leakage does not appear to be related to the method of assisted ventilation (invasive or non-invasive) or to the characteristic of the assistance mode (volume control or volume assist control).

Conclusion

The proposed method offers a reliable, non-invasive, continuous, bedside evaluation of air leak changes in ventilated patients. On-line analysis can be performed to find optimal ventilator settings in order to compensate for leakage while providing patient comfort.

Objectives

Understand mechanical forces applied on the temporo-mandibular joint by two different designs of mandibular advancement devices.

Methods and measurements

Rigid elements model of the temporo-mandibular joint, taking into account six muscles, was developed. A study is designed to compare traction based vs. compression based devices, with mandible in a 10 mm protrusion position. Static equilibrium can be written as hyperstatic equations and resolution is obtained through numeric optimization of different criteria under constraints.

Results

For compression based device, equation results show that important strength is applied in the masseter and posterior temporal. As both muscles lift the mandible up, this implies mouth opening happens when these muscles are at rest. However, the traction based device enables 10 mm protrusion with minimal effort on these muscles. Additionally, joint contact strength is consistently less (10%) with traction based device than with compression based device.

Conclusion

This simple mechanical model enables comparison of mandibular advancement devices with different modes of action. The results found are consistent with the ones from literature. Findings on studied parameters (mouth opening, joint contact strength) may imply an improved side-effect and a compliance profile in clinical practice for traction-based over compression-based mechanisms.

Living tissues are mainly constituted of soft matter. This so particular state, neither liquid, neither gas, nor solid led to the use, in simulation, of increasingly complicated mathematical models. These tissues are organised in multi-layers, present anisotropic properties and nonlinear behaviour. The evaluation of the interface pressure by traditional rigid sensors leads to errors of measurement. The device FORSAFE performs the measurement of the pressure on the fetal head. It is aimed to limit the risks due to a bad positioning and a too important tightening of the forceps on the head of the new-born, during the childbirth. It is based on an original method bio-inspired reproducing the sense of touch, by micro-palpations. Complications in forceps deliveries are rare but their consequences might be dramatics. This situation could be avoided if the obstetrician knows the information concerning symmetry of the obstetrical forceps position on the fetal head and the related interface pressure. Indeed, forceps delivery is an emergency gesture which is normally not expected. The aims of the FORSAFE device are: first, to prevent instrumented delivery accidents, secondly, to provide a safe training of forceps technique. This paper presents the original method of the interface pressure measurement, the results obtained on a physical model of interface pressure as well as the corrections performed on the probe placed on the forceps.

Regional and University Hospitals of Lille holds many of analysis laboratories with a great diversity of biology specialities. To date, a great biology center is building to accommodate there all these laboratories at the beginning of 2007. In this biology center, a room of metrology is foreseen where will be carried out the update of the metrological checks on the equipment concerned and the metrological traceability. The analysis laboratories of medical biology must have a perfect control of their equipment within the framework of the analytical process in order to ensure the quality of their results. This first work is a reflection on the failures of the metrology function within the laboratories from the biomedical point of view. Finally, the objective will be to provide to the laboratories of a coherent and homogeneous metrology tool to all the specialities of the biology of the CHRU of Lille to the service of their quality assurance.