The Sensing Endotracheal Tube

Current pulse oximetry sensors are not very wellsuited to use in anaesthetised patients as it has been shownthat during episodes of reduced peripheral circulation they donot function correctly or fail all together [1], [2]. To addressthis problem a new design for a photoplethysmography (PPG)endotracheal (ET) sensor to monitor pulse rate and oxygensaturation (SpO2) internally is presented. Flexible printedcircuit board (PCB) technology and miniature optoelectroniccomponents have been implemented and integrated with acustom instrumentation system [3]. The sensor adheres andconforms to the curvature of standard french-gauge 7 and 8ET tubes at the point just above the inflatable cuff within thelaryngeal positioning markings. A 3D-modelled, optically clear,soft silicon encapsulation electronically and thermally isolatesthe electronic components whilst providing a smooth surface toaid the insertion on the ET tube during standard intubationprocedures. A pilot study with 5 patients (3 Female, 2 Male),undergoing abdominal and limb laproscopic procedures hasdemonstrated the operation of the sensing ET tube, showinggood quality red and infra-red PPG signals. Preliminary signalanalysis reveals heart rate can be measured via PPG success-fully, with saturation (SpO2) readings in close agreement withthe commercial monitors of 97.9% (STD 0.2%) and 98.6% (STD 0.8%) respectivel

A Novel Photoplethysmography Sensor for Vital Signs Monitoring from the Human Trachea

Current pulse oximeter sensors can be challenged in working accurately and continuously in situations of reduced periphery perfusion, especially among anaesthetised patients. A novel tracheal photoplethysmography (PPG) sensor has been developed in an effort to address the limitations of current pulse oximeters. The sensor has been designed to estimate oxygen saturation (SpO2) and pulse rate, and has been manufactured on a flexible printed circuit board (PCB) that can adhere to a standard endotracheal (ET) tube. A pilot clinical trial was carried out as a feasibility study on 10 anaesthetised patients. Good quality PPGs from the trachea were acquired at red and infrared wavelengths in all patients. The mean SpO2 reading for the ET tube was 97.1% (SD 1.0%) vs. the clinical monitor at 98.7% (SD 0.7%). The mean pulse rate for the ET sensor was 65.4 bpm (SD 10.0 bpm) vs. the clinical monitor at 64.7 bpm (SD 9.9 bpm). This study supports the hypothesis that the human trachea could be a suitable monitoring site of SpO2 and other physiological parameters, at times where the periphery circulation might be compromised

Computational Analysis of Pulsed Radiofrequency Ablation in Treating Chronic Pain

In this paper, a parametric study has been conducted to evaluate the effects of frequency and duration of the short burst pulses during pulsed radiofrequency ablation (RFA) in treating chronic pain. Affecting the brain and nervous system, this disease remains one of the major challenges in neuroscience and clinical practice. A two-dimensional axisymmetric RFA model has been developed in which a single needle radiofrequency electrode has been inserted. A finite-element-based coupled thermo-electric analysis has been carried out utilizing the simplified Maxwell’s equations and the Pennes bioheat transfer equation to compute the electric field and temperature distributions within the computational domain. Comparative studies have been carried out between the continuous and pulsed RFA to highlight the significance of pulsed RFA in chronic pain treatment. The frequencies and durations of short burst RF pulses have been varied from 1 Hz to 10 Hz and from 10 ms to 50 ms, respectively. Such values are most commonly applied in clinical practices for mitigation of chronic pain. By reporting such critical input characteristics as temperature distributions for different frequencies and durations of the RF pulses, this computational study aims at providing the first-hand accurate quantitative information to the clinicians on possible consequences in those cases where these characteristics are varied during the pulsed RFA procedure. The results demonstrate that the efficacy of pulsed RFA is significantly dependent on the duration and frequency of the RF pulses

Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications—a review

Item does not contain fulltextBACKGROUND: The objective of this review is to evaluate the efficacy of Pulsed Radiofrequency (PRF) treatment in chronic pain management in randomized clinical trials (RCTs) and well-designed observational studies. The physics, mechanisms of action, and biological effects are discussed to provide the scientific basis for this promising modality. METHODS: We systematically searched for clinical studies on PRF. We searched the MEDLINE (PubMed) and EMBASE database, using the free text terms: pulsed radiofrequency, radio frequency, radiation, isothermal radiofrequency, and combination of these. We classified the information in two tables, one focusing only on RCTs, and another, containing prospective studies. Date of last electronic search was 30 May 2010. The methodological quality of the presented reports was scored using the original criteria proposed by Jadad et al. FINDINGS: We found six RCTs that evaluated the efficacy of PRF, one against corticosteroid injection, one against sham intervention, and the rest against conventional RF thermocoagulation. Two trials were conducted in patients with lower back pain due to lumbar zygapophyseal joint pain, one in cervical radicular pain, one in lumbosacral radicular pain, one in trigeminal neuralgia, and another in chronic shoulder pain. CONCLUSION: From the available evidence, the use of PRF to the dorsal root ganglion in cervical radicular pain is compelling. With regards to its lumbosacral counterpart, the use of PRF cannot be similarly advocated in view of the methodological quality of the included study. PRF application to the supracapular nerve was found to be as efficacious as intra-articular corticosteroid in patients with chronic shoulder pain. The use of PRF in lumbar facet arthropathy and trigeminal neuralgia was found to be less effective than conventional RF thermocoagulation techniques

Effect Sizes in Experimental Pain Produced by Gender, Genetic Variants and Sensitization Procedures

Background: Various effects on pain have been reported with respect to their statistical significance, but a standardized measure of effect size has been rarely added. Such a measure would ease comparison of the magnitude of the effects across studies, for example the effect of gender on heat pain with the effect of a genetic variant on pressure pain. Methodology/Principal Findings: Effect sizes on pain thresholds to stimuli consisting of heat, cold, blunt pressure, punctuate pressure and electrical current, administered to 125 subjects, were analyzed for 29 common variants in eight human genes reportedly modulating pain, gender and sensitization procedures using capsaicin or menthol. The genotype explained 0–5.9% of the total interindividual variance in pain thresholds to various stimuli and produced mainly small effects (Cohen's d 0–1.8). The largest effect had the TRPA1 rs13255063T/rs11988795G haplotype explaining >5% of the variance in electrical pain thresholds and conferring lower pain sensitivity to homozygous carriers. Gender produced larger effect sizes than most variant alleles (1–14.8% explained variance, Cohen's d 0.2–0.8), with higher pain sensitivity in women than in men. Sensitization by capsaicin or menthol explained up to 63% of the total variance (4.7–62.8%) and produced largest effects according to Cohen's d (0.4–2.6), especially heat sensitization by capsaicin (Cohen's d = 2.6). Conclusions: Sensitization, gender and genetic variants produce effects on pain in the mentioned order of effect sizes. The present report may provide a basis for comparative discussions of factors influencing pain

The Biology and Economics of Coral Growth

To protect natural coral reefs, it is of utmost importance to understand how the growth of the main reef-building organisms—the zooxanthellate scleractinian corals—is controlled. Understanding coral growth is also relevant for coral aquaculture, which is a rapidly developing business. This review paper provides a comprehensive overview of factors that can influence the growth of zooxanthellate scleractinian corals, with particular emphasis on interactions between these factors. Furthermore, the kinetic principles underlying coral growth are discussed. The reviewed information is put into an economic perspective by making an estimation of the costs of coral aquaculture