Journal articles on the topic 'Medical Pneumatic Device'
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1
Makarov, A. M., I. I. Davydova, K. A. Drapak, and E. G. Krylov. "AUTOMATED MEDICAL AND HEALTH-IMPROVING DEVICE." IZVESTIA VOLGOGRAD STATE TECHNICAL UNIVERSITY, no. 8(255) (August 31, 2021): 75–78. http://dx.doi.org/10.35211/1990-5297-2021-8-255-75-78.
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The article presents a pneumatic and functional diagram of an automated medical and health-improving device (LOW), the structure of the matrix of pneumatic chambers along the length and width of the LOW and a diagram of the distribution of the human body load on the LOW, depending on the ratio of the load on the surface, are developed.
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Sénac, Thibault, Arnaud Lelevé, Richard Moreau, Cyril Novales, Laurence Nouaille, Minh Tu Pham, and Pierre Vieyres. "A Review of Pneumatic Actuators Used for the Design of Medical Simulators and Medical Tools." Multimodal Technologies and Interaction 3, no. 3 (July 2, 2019): 47. http://dx.doi.org/10.3390/mti3030047.
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Simulators have been traditionally used for centuries during medical gestures training. Nowadays, mechatronic technologies have opened the way to more evolved solutions enabling objective assessment and dedicated pedagogic scenarios. Trainees can now practice in virtual environments representing various kind of patient and body parts including physio-pathologies issues. Gestures, to be mastered, vary according to each medical specialty (e.g., ultrasound probe orientations, or forceps installation during assisted delivery). Hence, medical students need kinesthetic feedback in order to significantly improve their learning capabilities. Gesture simulators require haptic devices with variable stiffness actuators. Existing solutions do not always fit the requirements because of their significant size. Contrary to electric actuators, pneumatic technology is low-cost, available off-the-shelf and offers a better mass–power ratio. However, it presents two main drawbacks: nonlinear dynamics and need for a compressed air supply. During the last decade, we have developed several haptic solutions based on pneumatic actuation (e.g., birth simulator, epidural needle insertion simulator) and, recently, in a joint venture with Prisme laboratory, a pneumatic probe master device for remote ultrasonography. This paper recalls literature scientific approaches on pneumatic actuation developed in the medical context and illustrated with the aforementioned applications to highlight the benefits.
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Chien, Tzu-I., Huey-Wen Liang, Ya-Fen Lee, Fei-Yun Liu, Chi-Kwang Hsu, Shao-Tseng Liu, Mo Siu-Mei Lee, and Pin-Fei Wei. "Evaluation of Newly Developed Easy-Open Assistive Devices for Pneumatic Tube System Carriers for the Reduction of Work-Related Musculoskeletal Disorders." BioMed Research International 2021 (January 8, 2021): 1–12. http://dx.doi.org/10.1155/2021/8853602.
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Musculoskeletal disorders may affect labor efficiency, cause disability, impair one’s work ability, and lower one’s quality of life. This consequently leads to a larger expenditure of medical resources. We aimed to design easy-to-open assistive devices for pneumatic tube systems to improve ergonomics and reduce musculoskeletal complaints of workers. We followed a design control process, including designs of motors, gears, sensors, and V-shaped connecting rods. Efficacy was evaluated by examining risks based on job strain index, user satisfaction, and musculoskeletal complaints of operators before and after the system’s implementation on a Nordic musculoskeletal questionnaire. We designed three assistive devices: two semiautomatic and one automatic. Each semiautomatic device costs about 300 US dollars and required space of 10 × 18 × 38 c m 3 . The automatic device costs about 3000 US dollars and required space of 28 × 38 × 50 c m 3 . The job strain index score decreased from 36 (very high risk) to 3 (low risk) with the semiautomatic devices and to 0 with the automatic device. Musculoskeletal complaints in the neck and upper limbs were reduced, with a significantly higher satisfaction rate for female operators. Our novel design of an automatic cap opening device for a pneumatic tube system was effective in improving ergonomics and reducing musculoskeletal complaints.
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Saga, Norihiko, Naoki Saito, and Jun-ya Nagase. "Ankle Rehabilitation Device to Prevent Contracture Using a Pneumatic Balloon Actuator." International Journal of Automation Technology 5, no. 4 (July 5, 2011): 538–43. http://dx.doi.org/10.20965/ijat.2011.p0538.
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Our proposed rehabilitation device to prevent contracture of the ankle is easy to produce, transport, and install at the time of use in places such as medical institutions. This device is intended for use by hemiplegic people. The ankle is moved when it is worn, preventing ankle contracture. It consists of a new tendon-drive system using a pneumatic balloon actuator, power transfer mechanism, and ankle foot orthosis. This new tendon drive system using a pneumatic balloon was developed as an actuator of this device. The system consists of a tendon and a silicone tube. Both ends of the tube are closed. The tube expands with the supplied air, which distends the silicone tube and thereby pulls the tendon. This simple system is both compact and powerful. Furthermore, its materials and structure make it light. This paper describes characteristics of this tendon drive system using a pneumatic balloon, along with its composition and operation as a rehabilitation device for preventing ankle contracture. Results of operation tests using the device are also presented.
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PASHKOV, E. V., V. P. POLIVTSEV, and V. V. POLIVTSEV. "AUTOMATIC DEVICE FOR CARDIAC-PULMONARY REANIMATION ON THE BASIS OF LINEAR PNEUMATIC DRIVE." Fundamental and Applied Problems of Engineering and Technology 4, no. 1 (2020): 74–79. http://dx.doi.org/10.33979/2073-7408-2020-342-4-1-74-79.
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The results of the analysis of the designs and functional capabilities of a number of devices for cardiopulmonary resuscitation by well-known manufacturers of medical equipment are presented, the basic schemes of force action on the chest are considered, the disadvantages that narrow the functionality and reliability of the devices are identified. A description is given of the design and principle of operation of an original automatic device for cardiopulmonary resuscitation based on a linear pneumatic drive with a tape chest bandage and with varying parameters of force exposure, depending on the size of the chest.
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McSwain, Norman E. "Medical Anti-Shock Trousers: Pneumatic Anti-Shock Garment: Does it Work?" Prehospital and Disaster Medicine 4, no. 1 (September 1989): 42–44. http://dx.doi.org/10.1017/s1049023x00038541.
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The use of the Pneumatic Anti-Shock Garment (PASG) has created much controversy in prehospital care. It is interesting that such an inexpensive device and technique has created so much controversy regarding effectiveness when expensive devices and techniques, such as coronary artery bypass, carotid endarteroectomy, and laser angioplasty have been questioned as to effectiveness, but have not created as much controversy.Where do we stand on the PASG today? One well-done, randomized, prospective study has been reported as several different papers. In reality, these reports originate from only one study (1-5). This is compared to more than 200 other studies, many of which have been randomized, prospective studies in animals using the same quality as the randomized, prospective study done on humans. Such studies have the advantage of having better isolation of the specific condition being studied. It does not seem appropriate to base the clinical use or non-use on just one study. All studies should be reviewed and placed in context when attempting to identify the role the PASG has in patient care.
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Ribuan, Mohamed Najib, Shuichi Wakimoto, Koichi Suzumori, and Takefumi Kanda. "Omnidirectional Soft Robot Platform with Flexible Actuators for Medical Assistive Device." International Journal of Automation Technology 10, no. 4 (July 5, 2016): 494–502. http://dx.doi.org/10.20965/ijat.2016.p0494.
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This manuscript explains the employment of flexible actuators to act as a soft robot and transporting agent to assist medical X-ray examinations. Although soft robots from silicone material can be transparence and a human compliance used as medical assistive devices, soft robots have some problems: they tend to be sluggish, have long and imprecise gait trajectories, and need their control parameters to be adjusted for motion diversion. A soft robot with omnidirectional locomotion has been created, one that has a combination of pneumatic rubber legs that form a soft robot platform and an associated hardware setup. Tests have confirmed its omnidirectional locomotion ability; it has a maximum speed of 6.90 mm/s in forward locomotion and a maximum payload of 70 g. These features indicate that the robot can be used as a medical assistive device for fluoroscopy examinations.
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Wakimoto, Shuichi, Issei Kumagai, and Koichi Suzumori. "Development of Variable Stiffness Colonoscope Consisting of Pneumatic Drive Devices." International Journal of Automation Technology 5, no. 4 (July 5, 2011): 551–58. http://dx.doi.org/10.20965/ijat.2011.p0551.
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Colonoscopy is important and effective medical procedure to detect colonic disorder including cancer of the colon. However, because the large intestine is soft and complex shape, insertion of conventional colonoscopes into the large intestine is difficult, and it depends on doctors’ skill strongly. In many cases, patients feel strong pain. In this research, we aim at development of a novel colonoscope which can change own stiffness partially and realize safe insertion without special techniques. The colonoscope consists of variable stiffness devices. The device is made from silicone rubber and can change its stiffness by pneumatic pressure. In this report, two kinds of variable stiffness devices made from different silicone rubber materials have been developed by molding, and stiffness change characteristics of them are shown experimentally. By applying not only positive pneumatic pressure but also negative pressure, widely stiffness change range is realized. Additionally colonoscopes have been fabricated using them and FMA (Flexible Microactuator). From insertion experiments into the large intestine phantom, advantages and effectiveness have been recognized.
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Gokhale, S. D., Sourabh A. D, Omkar C. K, Prathamesh D. K, and Tanmay J. Y. "Pneumatic Cervical Traction Machine with Monitor and Control." International Journal for Research in Applied Science and Engineering Technology 11, no. 1 (January 31, 2023): 284–86. http://dx.doi.org/10.22214/ijraset.2023.48473.
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Abstract: The practice of spinal traction goes back to the fourth century BC, where Hippocrates first described it as a treatment for kyphosis. It was subsequently implemented in other spinal pathologies including cervical pain and myelopathy. In the 1600s, the Germans employed cervical traction in their medical practice, as an adjunct to open reduction of cervical dislocations, and fractures. In 1929, the Halter device was introduced for the reduction of cervical injuries; then several other devices followed to ensure more efficient traction. To date, there is no accurate description of the mechanism of relief provided by cervical traction. The theory behind its efficiency emphasizes the widening of the intervertebral foramen upon traction, with separation of the facet joint. This will relieve the sustained pressure on the nerve roots, and hence alleviate symptoms of radiculopathy. Other theories suggest that relaxation, and is not involved in intervertebral separation.
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Horie, Toshiaki, and Satoshi Konishi. "Stepwise Locomotion on a Deformable Surface Using Shear Displacement Produced by a Pneumatic Suction Device." Journal of Robotics and Mechatronics 21, no. 1 (February 20, 2009): 74–80. http://dx.doi.org/10.20965/jrm.2009.p0074.
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The present paper introduces a stepwise locomotion of a micro robot using the shear displacement of a deformable object by a pneumatic suction device. We consider a locomotion function of a micro robot for medical application. A medical micro robot introduced into the abdominal cavity has been investigated as an extension of endoscopic technology. A micro robot with a locomotion function can be made to move within the body when performing medical examinations or surgery. The proposed locomotion mechanism employs suction devices in order to provide a shear displacement as well as stable contact with the object. The proposed stepwise locomotion mechanism does not require an additional stretching actuator for inchworm motion. The present paper describes the design, implementation, characterization, and demonstration of a micro robot based on the proposed locomotion principle. The micro robot will successfully demonstrate one-dimensional, two-dimensional, and diagonal movements, and an in vitro experiment will be conducted as a representative medical application.
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Konishi, Satoshi, Toshiaki Horie, Yoshimasa Kurumi, and Toru Tani. "Reliable Positioning of Micro Device for Medical Diagnosis and Operation on Pulsating Targets by Pneumatic Suction Device." Journal of Japan Society of Computer Aided Surgery 11, no. 2 (2009): 59–64. http://dx.doi.org/10.5759/jscas.11.59.
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Ionescu, Mircea, and Ileana Constanţa Roșca. "Rapid Prototyping of a Hand Model for Rehabilitation." Applied Mechanics and Materials 245 (December 2012): 85–89. http://dx.doi.org/10.4028/www.scientific.net/amm.245.85.
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Studies and researches in medical devices made evident the need of new systems and technologies for locomotors recovery of human body as to reduce the reintegration time in normal activities and, not the least, to improve the recovery quality, to give the possibility to perform natural movements identical to those before the suffered injury. Thus, the purpose of this paper is to obtain the 3D virtual model of a mechanism describing the hand kinematics, and a real medical prototype device to be used in locomotors recovery of the hand. In order to perform the movements, pneumatic fluidic actuators are used, considering that they are flexible, small, made especially for this project. A specialized software for assisted design is used to obtain the virtual model and for the fabrication of device component parts Rapid-Prototyping technology is applied, the Fused Deposition Modeling principle (FDM).
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Tu, Thanh Diep Cong. "CONTROL NOVEL MODEL OF KNEE CPM DEVICE." Science and Technology Development Journal 12, no. 4 (February 28, 2009): 18–29. http://dx.doi.org/10.32508/stdj.v12i4.2228.
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In recent years, CPM - Continuous Passive Motion has been proved to be one of the most effective therapeutic methods for patients who have problems with motion such as spinal cord injury, ankle and knee injury, parkinson and so on. Many commercial CPM devices are found in market but all of them use motors as the main actuators. The lack of human compliance of electric actuators, which are commonly used in these machines, makes them potentially harmful to patients. An interesting alternative, to electric actuators for medical purposes, particularly promising for rehabilitation, is a pneumatic artificial muscle (PAM) actuator because of its high power/weight ratio and compliance properties. However, the highly nonlinear and hysteresis of PAM make it the challenging for design and control. In this study, a PID compensation using neural network control is studied to improve the control performance of the novel model of Knee CPM device.
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Chappel, Eric. "Dry Test Methods for Micropumps." Applied Sciences 12, no. 23 (November 30, 2022): 12258. http://dx.doi.org/10.3390/app122312258.
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The test in the production of microfluidic devices dedicated to medical applications poses several challenges in terms of contamination, reliability, and cost. The present article describes the Design-for-Testability approach used to make an insulin MEMS micropump that can be fully tested in production in a few seconds. Each key functional parameter of a positive displacement micropump with check valves is described together with detailed pneumatic test methods. The typical failure modes of the device are considered and tested experimentally to show that these methods can also be used for failure analysis and process control. A simplified Built-In-Self-Test is also presented. Finally, advanced methods to characterize the piezoelectric actuator are also described and tested.
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Krumpholz, Roman, Jonas Fuchtmann, Maximilian Berlet, Annika Hangleiter, Daniel Ostler, Hubertus Feussner, and Dirk Wilhelm. "Telemedical percussion: objectifying a fundamental clinical examination technique for telemedicine." International Journal of Computer Assisted Radiology and Surgery 17, no. 4 (November 24, 2021): 795–804. http://dx.doi.org/10.1007/s11548-021-02520-z.
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Abstract Purpose While demand for telemedicine is increasing, patients are currently restricted to tele-consultation for the most part. Fundamental diagnostics like the percussion still require the in person expertize of a physician. To meet today’s challenges, a transformation of the manual percussion into a standardized, digital version, ready for telemedical execution is required. Methods In conjunction with a comprehensive telemedical diagnostic system, in which patients can get examined by a remote-physician, a series of three robotic end-effectors for mechanical percussion were developed. Comprising a motor, a magnetic and a pneumatic-based version, the devices strike a pleximeter to perform the percussion. Emitted sounds were captured using a microphone-equipped stethoscope. The 84 recordings were further integrated into a survey in order to classify lung and non-lung samples. Results The study with 21 participants comprised physicians, medical students and non-medical-related raters in equal parts. With 71.4% correctly classified samples, the ventral motorized device prevailed. While the result is significantly better compared to a manual or pneumatic percussion in this very setup, it only has a small edge over the magnetic devices. In addition, for all ventral versions non-lung regions were rather correctly identified than lung regions. Conclusion The overall setup proves the feasibility of a telemedical percussion. Despite the fact, that produced sounds differ compared to today’s manual technique, the study shows that a standardized mechanical percussion has the potential to improve the gold standard’s accuracy. While further extensive medical evaluation is yet to come, the system paves the way for future uncompromised remote examinations.
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Mecker, Laura C., and R. Scott Martin. "Coupling Microdialysis Sampling to Microchip Electrophoresis in a Reversibly Sealed Device." JALA: Journal of the Association for Laboratory Automation 12, no. 5 (October 2007): 296–302. http://dx.doi.org/10.1016/j.jala.2007.04.008.
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In this article, we describe the fabrication and characterization of a reversibly sealed microchip device that is used to couple microdialysis sampling to microchip electrophoresis. The ability to interface microdialysis sampling and microchip electrophoresis in a device that is amenable to reversible sealing is advantageous from a repeated use standpoint. Commercially, available tubing coming from the microdialysis probe is directly inserted into the chip and flow from the probe is interfaced to the electrophoresis portion of the device through integrated pneumatic valves. Fluorescence detection was used to characterize the poly(dimethylsiloxane)-based device in terms of injection reproducibility. It was found that the entire system (microdialysis probe and microchip device) has a concentration response lag time of 170 s. Microdialysis sampling followed by an electrophoretic separation of amino acids derivatized with naphthalene-2,3-dicarboxaldehyde/cyanide was also demonstrated.
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Deaconescu, Tudor, and Andrea Deaconescu. "Static analysis of a torsion motor generating flexion - extension motions of the elbow." MATEC Web of Conferences 178 (2018): 07005. http://dx.doi.org/10.1051/matecconf/201817807005.
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The paper presents the construction and static analysis of a rotation module responsible for conducting flexion-extension motions as part of a medical rehabilitation device of the elbow. The rotation module is actuated by a torsion motor consisting of a pair of agonist-antagonist pneumatic muscles. The study concerning the static behaviour of the rotation module draws upon similarity to the biological model, considering the influence of the neuronal control quantities on the forces developed by the two muscles.
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Baayoun, Mohamad, Naseem Daher, and Matthias Liermann. "Reduced order indirect self-tuning regulator for a novel pneumatic tele-operation system." Proceedings of the Institution of Mechanical Engineers, Part I: Journal of Systems and Control Engineering 234, no. 3 (June 10, 2019): 370–83. http://dx.doi.org/10.1177/0959651819854557.
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This article presents a reduced order indirect self-tuning regulator for a passive pneumatic tele-operation system, which is intended for use in medical surgeries in magnetic resonance imaging environments with short transmission distances ([Formula: see text]), where force feedback is required. The novel tele-operation system uses less active components as compared to conventional systems and realizes a bilateral control without the use of a force or pressure sensor. The proposed adaptive control system is validated in simulation and experimentation on a test rig built for this purpose. Special attention is given to the notion of transparency of the system, which is the ratio between the resistance of the master device experienced by the operator and the actual resistance of the remote environment in contact with the slave device. The adaptive controller shows advantage over a previously designed non-adaptive control system design in terms of stiffness, damping, and transparency.
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Mattox, Kenneth. "Medical Anti-Shock Trousers: Blind Faith, Poor Judgment and Patient Jeopardy." Prehospital and Disaster Medicine 4, no. 1 (September 1989): 39–41. http://dx.doi.org/10.1017/s1049023x0003853x.
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The oft-repeated historic development of the pneumatic lower body compression suit (MAST, PASG) for the presumed treatment of hypotension has been well-documented by McSwain(l). While the experimental and anecdotal clinical observations of Crile, Gardner, Wangenstein and Kaplan are interesting, they are not prospective, controlled, randomized clinical trials in humans(2,3,4,5). In the early 1970s, the EMS community was ripe for the bandwagon reflex to grasp at any and all gimmicks and gadgets which became available, regardless of a lack of evidence regarding their safety or danger to patients. Inventions such as the esophageal obturator airway, various darts, MAST, external cardiac bumpers, percutaneous trachea obturators, and many others simultaneously were thrust upon the unsuspecting and unprotected patient community. Some of these innovations may have been beneficial but others were dangerous. Contending that some intervention in a “life threatening, good Samaritan situation” was better than no interventional treatment or “stabilization” at all, the paramedics' blind faith in these modalities persisted. The Medical Device Amendment of 1976 (6), which requires safety and efficacy for devices, similar to that long in effect for new drugs, had not yet been enacted into law to require premarketing clearance of new medical devices. Building on blind faith and premature recommendations regarding in the unproven concept of MAST, the EMS community exercised poor judgment in recommending to state legislators that this unproven device be “required equipment” on board ambulances. Furthermore, this small cadre of “special interest groups” lobbied to have the MAST mandated as essential equipment in trauma centers(7,8). Although the minutes of the trauma planning meetings do not reflect the debate at the American College of Surgeons Committee on Trauma, numerous voices of advised constraint, said “go slow” on including the MAST as part of the ATLS course and the ACS optimal resources document.
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Kavros, Steven J. "The Efficacy of a Pneumatic Compression Device in the Treatment of Plantar Fasciitis." Journal of Applied Biomechanics 21, no. 4 (November 2005): 404–13. http://dx.doi.org/10.1123/jab.21.4.404.
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Plantar fasciitis is a common foot disorder that affects more than two million Americans each year. Conservative management of plantar fasciitis is the first line of treatment by the medical specialist who frequently encounters this common foot complaint. In this study, 50 patients with plantar fasciitis of 4 weeks duration but less than 12 weeks were randomized into two groups. One group of 25 patients used the AirHeel (Aircast, Inc.) and the second group of 25 used the 1st Step prefabricated foot insert (Wrymark, Inc). Standardized weight-bearing radiographs were obtained in order to categorize the foot type: normal arch, pes planus, or pes cavus. Patients were initially evaluated and at 12 weeks they returned for a subsequent visit. The contact area of the foot with the AirHeel and 1st Step insert were similar, an increase of 27% and 26%, respectively, over the contact area barefoot. There was a noted difference in force reduction with the two devices. The AirHeel reduced the midstance force by 20.19%, as compared to the 1st Step insert which showed a 1.03% increase in midstance force. Patients with a higher initial pain score seemed to respond better initially to the AirHeel (p= 0.015) than the 1st Step insert (p= 0.035). This study demonstrates the benefits of offloading the foot at midstance with two devices to relieve the discomfort associated with plantar fasciitis. The Aircast AirHeel is a new modality for dynamic, functional treatment of proximal plantar fasciitis.
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Chang, Chen Min, S. K. Hsiung, and Gwo Bin Lee. "A Micromachine-Based Flow Cytometer Chip Integrated with Micro-Pumps/Valves for Multi-Wavelength Detection Applications." Materials Science Forum 505-507 (January 2006): 637–42. http://dx.doi.org/10.4028/www.scientific.net/msf.505-507.637.
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This study presents a new micromachine-based cell counting and sorting system capable of multi-wavelength detection for biological applications. Chip-based flow cytometers have been extensively investigated recently. Several unique features have been integrated on this new cell-analysis system. First, a series of new serpentine-shape pneumatic micro-pumps were used to drive sample and sheath flows and generate a hydrodynamic focusing effect. The control of fluids could be achieved with ease by using this approach. Multiple embedded optical fibers were then used to transmit the light source and collect induced fluorescence signals in and out of the chip device. Cells labeled with different fluorescent dyes could be then individually detected by corresponding fibers using lasers with different wavelengths. Finally, three pneumatic micro-valves downstream were used for cell sorting. The developed micro flow cytometer could be used for fast analysis of cell-related bio-medical applications.
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Nowottnick, Mathias, Lienhard Pagel, and Stefan Gassmann. "Fluidic Devices in PCB Technology." Additional Conferences (Device Packaging, HiTEC, HiTEN, and CICMT) 2010, DPC (January 1, 2010): 000557–78. http://dx.doi.org/10.4071/2010dpc-ta21.
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Printed circuit boards (PCB) are widely used in electronics. They have the wiring and holding task for electronic devices. With the adding of more and more functionality to miniaturized devices the PCBs have to include more and more functionality. However, the usage of PCBs in fluidic applications is rare. Adding a fluidic functionality to a PCB will create intelligent fluidic systems at low cost. At the University of Rostock a special technology for creating fluidic systems in PCBs is developed. Low-Flow micro systems as well as High-Flow systems are feasible. The main advantage using PCBs is to create compact devices at low cost. In this paper an overview is given over the devices made at the University of Rostock. This description include low flow devices like a thermopneumatical driven pump, a bimetal valve, a pressure sensor with force compensation, a bubble detector and static mixers. As well as a high flow device, the insufflator. The insufflator is a medical device where a flow rate of up to 45l/min has to be realized. This is a very good example for the high flow fluidic PCB technology where normal multi layer PCBs are used to hold the channels inside the PCB and connect pneumatic components electrically and pneumatically on the same substrate. A short introduction to both technologies is given and the function of the devices is explained.
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Shkundin, S. Z., A. V. Skorobogatov, I. N. Piktushanskaya, and V. I. Kutovoi. "Development of Device for Electrothermometry with Cold Test in Patients with Pneumatic Hammer Disease." Biomedical Engineering 42, no. 6 (November 2008): 326–30. http://dx.doi.org/10.1007/s10527-009-9076-x.
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Desai, Sanjay C., Nicholas Inston, and Alexandros Mallios. "A new approach to vein and arteriovenous fistula dilation." Journal of Kidney Care 5, no. 2 (March 2, 2020): 79–84. http://dx.doi.org/10.12968/jokc.2020.5.2.79.
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Dr Sanjai Desai, Dr Nicholas Inston, and Dr Alexandros Mallios provide an update on a new method to enhance vascular access outcomes for dialysis patients. While arteriovenous fistulas (AVFs) are the ‘gold standard’ for haemodialysis access, the path to a functional AVF is steep, and far too many fail before they can be used for dialysis. Fist Assist, a lightweight, wearable medical device, provides gentle, intermittent pneumatic compression that can safely and effectively help veins to enlarge before, and after, AVF surgery. This article covers the risks of AVF failure, early research with Fist Assist on dilation, a concise cost analysis, and the potential for such a device to improve outcomes for both percutaneous and standard AVFs. Fist Assist is expected to launch in Europe in March 2020.
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Kobayashi, Wataru, Hiroaki Tamaki, Tetsuya Akagi, Shujiro Dohta, and So Shimooka. "Development of Flexible Electro-Hydraulic Spherical Actuator." Journal of Robotics and Mechatronics 34, no. 2 (April 20, 2022): 382–89. http://dx.doi.org/10.20965/jrm.2022.p0382.
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Voluntary rehabilitation at home helps to prevent the joint contracture after medical treatment. Our previous studies concerned a low-cost portable rehabilitation device using a flexible spherical pneumatic actuator as a passive exercise device. However, the device requires a bulky compressor to drive it. This study results in a compact fluidic driving system that is highly flexible. The system adopts a flexible electro-hydraulic cylinder driven by an electric motor and a hydraulic gear pump. An empirical equation for the suitable pump rotation for the desired displacement of the system has been determined. As a result, the multi-position control of the system within the tracking error of 4 mm has been realized by using the on/off control scheme based on the obtained equation. In addition, a flexible, spherical electro-hydraulic actuator using two proposed drive systems is developed and tested. Control of the attitude of the tested spherical actuator is successfully realized.
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Martin, Jeffrey S., Zachary D. Friedenreich, Alexandra R. Borges, and Michael D. Roberts. "Preconditioning with peristaltic external pneumatic compression does not acutely improve repeated Wingate performance nor does it alter blood lactate concentrations during passive recovery compared with sham." Applied Physiology, Nutrition, and Metabolism 40, no. 11 (November 2015): 1214–17. http://dx.doi.org/10.1139/apnm-2015-0247.
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Application of dynamic external pneumatic compression (EPC) during recovery from athletic activities has demonstrated favorable effects on flexibility, soreness, swelling, and blood lactate (BLa) concentrations. However, the effects of “preconditioning” with a peristaltic pulse EPC device on subsequent performance and BLa concentrations have not been characterized. Herein, we demonstrate that pretreatment for 30 min with EPC has no effect on subsequent supramaximal exercise performance or BLa concentrations during passive recovery.
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Aleksandrowicz, Hubert, Agnieszka Owczarczyk-Saczonek, and Waldemar Placek. "Venous Leg Ulcers: Advanced Therapies and New Technologies." Biomedicines 9, no. 11 (October 29, 2021): 1569. http://dx.doi.org/10.3390/biomedicines9111569.
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The prevalence of venous leg ulcers (VLUs) differs between 1.5% and 3% in the general population. The challenge in treating VLUs is common recurrence. Moreover, VLUs can be resistant to healing, despite appropriate treatment. In these cases, advanced wound therapies should be considered. The number of new technologies, applied in VLUs treatment, has increased in the last years. These therapies include biophysical interventions such as ultrasound therapy, electrical stimulations, electromagnetic therapy, or phototherapy. Furthermore, stem cell therapies, biologic skin equivalents, platelet-rich plasma therapy, oxygen therapies, anti-TNF therapy, or negative pressure wound therapy are advanced venous ulcer therapeutic methods that may support the standard of care. Medical devices, such as a muscle pump activator, or intermittent pneumatic compression device, may be especially useful for specific subgroups of patients suffering from VLUs. Some of the above-mentioned technologies require broader evidence of clinical efficacy and are still considered experimental therapies in dermatology.
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Lichtenstein, O., and U. Dinnar. "Experimental Analysis of Pulsatile Flow Through Elastic Collapsible Tubes: Application to Cardiac Assist Device." Journal of Biomechanical Engineering 112, no. 1 (February 1, 1990): 75–79. http://dx.doi.org/10.1115/1.2891129.
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This study presents a simulated analysis of Phased Compression Cardiac Assist Device (PCCAD) and evaluation of its applicability as a non-invasive temporary assist for a failing heart. The new technique is based on the chest pump mechanism for blood flow augmentation during external massage by phased compression of the abdominal and thoracic cavities. A semi-closed hydraulic system to simulate the systemic circulation was constructed; the system includes a left ventricle which functions according to the Starling principle and a pneumatic system which controls the pressures applied to the thoracic and abdominal cavities, in complete synchronization with the beating normal or failing heart. The possibility of manipulating the three pumps in series (venous, heart, and arterial) has been checked, and the principal parameters which effect the efficiency of the PCCAD were evaluated. This in-vitro analysis shows the high potential of a non-invasive temporary cardiac assist device. It points to the necessary measures one has to take in order to achieve good synchronization and to interfere externally with the augmentation of cardiac output or with the augmentation of root aortic pressure.
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Broderick, Barry J., Gavin J. Corley, Fabio Quondamatteo, Paul P. Breen, Jorge Serrador, and Gearóid ÓLaighin. "Venous emptying from the foot: influences of weight bearing, toe curls, electrical stimulation, passive compression, and posture." Journal of Applied Physiology 109, no. 4 (October 2010): 1045–52. http://dx.doi.org/10.1152/japplphysiol.00231.2010.
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This study investigated the hemodynamic properties of the plantar venous plexus (PVP), a peripheral venous pump in the human foot, with Doppler ultrasound. We investigated how different ways of introducing mechanical changes vary in effectiveness of displacing blood volume from the PVP. The contribution of the PVP was analyzed during both natural and device-elicited compressions. Natural compressions consisted of weight bearing on the foot and toe curl exercises. Device-elicited compressions consisted of intermittent pneumatic compression (IPC) of the foot and electrically elicited foot muscle contractions. Ten healthy participants had their posterior tibial, peroneal, anterior tibial, and popliteal vein blood flow monitored while performing these natural and device-elicited compressions of the PVP supine and in an upright position. Results indicated that 1) natural compression of the PVP, weight bearing and toe curls, expelled a significantly larger volume of blood than device-elicited PVP compression, IPC and electrical stimulation; 2) there was no difference between the venous volume elicited by weight bearing and by toe curls; 3) expelled venous volume recorded at the popliteal vein under all test conditions was significantly greater than that recorded from the posterior tibial and peroneal veins; 4) there was no significant difference between the volume in the posterior tibial and peroneal veins; 5) ejected venous volume recorded in the upright position was significantly higher than that recorded in the supine position. Our study shows that weight bearing and toe curls make similar contributions to venous emptying of the foot.
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von Planta, I., M. H. Weil, M. von Planta, J. Bisera, S. Bruno, R. J. Gazmuri, and E. C. Rackow. "Cardiopulmonary resuscitation in the rat." Journal of Applied Physiology 65, no. 6 (December 1, 1988): 2641–47. http://dx.doi.org/10.1152/jappl.1988.65.6.2641.
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A standardized method of cardiopulmonary resuscitation in rodents has been developed for anesthetized, mechanically ventilated rats. Ventricular fibrillation was induced and maintained by an alternating current delivered to the right ventricular endocardium. After 4 min of ventricular fibrillation, the chest was compressed with a pneumatic piston device. Eight of 14 animals were successfully resuscitated with DC countershock after 6 min of cardiac arrest. In confirmation of earlier studies from our laboratories in dogs, pigs, and human patients, this rodent model of cardiopulmonary resuscitation demonstrated large venoarterial [H+] and PCO2 gradients associated with reduced pulmonary excretion of CO2 during the low-flow state. Mean aortic pressure, coronary perfusion pressure, and end-tidal CO2 during chest compression were predictive of successful resuscitation.
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Budnyk, Vitalii, Maksym Mudrenko, Serhii Lukash, and Mykola Budnyk. "Calibrating and Graduating of Multi-Sensor Gas Analyzer." Cybernetics and Computer Technologies, no. 3 (November 29, 2022): 87–97. http://dx.doi.org/10.34229/2707-451x.22.3.9.
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Introduction. The article is devoted to the calibration and graduation of the multi-sensor gas analyzer developed at the V.M. Glushkov Institute of Cybernetics of National Academy of Sciences of Ukraine. The modern trend in the development of medical equipment, in particular, containing built-in measuring devices, consists in its miniaturization, intellectualization, the use of information technologies, and the introduction of wireless and network means of data transmission. The purpose of the article is to design, create electronics and software for recording the concentration of three gases (oxygen, carbon dioxide and carbon monoxide), test and calibrate the device. Results. Three prototypes of sensor modules for oxygen, carbon dioxide and carbon monoxide have been created. The structure, scheme of connection of sensor modules, and the principle of operation of the gas analyzer was described. Testing and optimization of these prototypes were performed. Auxiliary pneumatic equipment for checking the performance of devices, their calibration and graduation was manufactured. Measurement technique was developed and test measurements of the specified gases were performed. The calibration technique was developed and the device was calibrated using two test gas samples such as ethanol vapor and air-gas mixture of carbon dioxide. In addition, a special software has been developed, which allow observe a registered input signal from sensor modules and store it to the file. Conclusions. As a result of the work, prototype of the device was created, its testing, calibration and graduation were carried out at the State Enterprise "Ukrmetrteststandart", 4 certificates of metrological attestation were obtained. The gas analyzer can be used for screening of healthy persons based on study of exhalation to predict the risk of diseases. Keywords: multi-sensor gas analyzer, oxygen, carbon dioxide, carbon monoxide, calibration, graduation.
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A., Oluwatosin, Lucia Y.O., Oluwadamilare A., and Prisca O.A. "Knowledge and Utilisation of Anti-Shock Garment Among Midwives of Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria." African Journal of Health, Nursing and Midwifery 4, no. 5 (August 9, 2021): 26–37. http://dx.doi.org/10.52589/ajhnm-u47saemp.
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Background and Aim: Postpartum Haemorrhage (PPH) is a leading cause of maternal mortality, yet it is one of the few obstetric complications, with proven and effective interventions. Non-Pneumatic Anti Shock Garment (NASG) is a high-quality, simple technology and low-cost first-aid device that reverses hypovolemic shock. While evidence has shown that this simple technology is effective in reducing PPH, the level of knowledge and utilisation is unclear. This underscored the need to assess the knowledge and utilisation of the NASG as a measure of controlling postpartum haemorrhage in Adeoyo Maternity Teaching Hospital, Yemetu, Ibadan. Methods: This study adopted a descriptive cross-sectional research design and questionnaires were used to gather data from the midwives. The convenience sampling technique was used to recruit one hundred and forty-four (144) midwives into the study. Data were analysed using version 21.0 of Statistical Package for Social Sciences (SPSS) using Chi-square. Results: The findings of this study revealed that although 97.9% of participants responded that they had seen NASG before, only about half (47.1%) could describe what it looked like. While 96.4% claimed that they knew how to use the NASG, only 73.7% of them actually use it each time there was PPH. No significant association was found between knowledge and utilisation of the equipment (p=.298). Factors associated with non-usage include non-availability, inexperience, lack of skilled personnel, and poor attitude. Conclusion: There was a good level of utilisation of the Non-Pneumatic Anti-Shock Garment for the management of postpartum haemorrhage, but only a few of the midwives were able to correctly describe it and not all were using it. Hence, refresher courses are hereby advocated to further improve NASG usage.
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Messere, Alessandro, Gianluca Ceravolo, Walter Franco, Daniela Maffiodo, Carlo Ferraresi, and Silvestro Roatta. "Increased tissue oxygenation explains the attenuation of hyperemia upon repetitive pneumatic compression of the lower leg." Journal of Applied Physiology 123, no. 6 (December 1, 2017): 1451–60. http://dx.doi.org/10.1152/japplphysiol.00511.2017.
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The rapid hyperemia evoked by muscle compression is short lived and was recently shown to undergo a rapid decrease even in spite of continuing mechanical stimulation. The present study aims at investigating the mechanisms underlying this attenuation, which include local metabolic mechanisms, desensitization of mechanosensitive pathways, and reduced efficacy of the muscle pump. In 10 healthy subjects, short sequences of mechanical compressions ( n = 3–6; 150 mmHg) of the lower leg were delivered at different interstimulus intervals (ranging from 20 to 160 s) through a customized pneumatic device. Hemodynamic monitoring included near-infrared spectroscopy, detecting tissue oxygenation and blood volume in calf muscles, and simultaneous echo-Doppler measurement of arterial (superficial femoral artery) and venous (femoral vein) blood flow. The results indicate that 1) a long-lasting (>100 s) increase in local tissue oxygenation follows compression-induced hyperemia, 2) compression-induced hyperemia exhibits different patterns of attenuation depending on the interstimulus interval, 3) the amplitude of the hyperemia is not correlated with the amount of blood volume displaced by the compression, and 4) the extent of attenuation negatively correlates with tissue oxygenation ( r = −0,78, P < 0.05). Increased tissue oxygenation appears to be the key factor for the attenuation of hyperemia upon repetitive compressive stimulation. Tissue oxygenation monitoring is suggested as a useful integration in medical treatments aimed at improving local circulation by repetitive tissue compression. NEW & NOTEWORTHY This study shows that 1) the hyperemia induced by muscle compression produces a long-lasting increase in tissue oxygenation, 2) the hyperemia produced by subsequent muscle compressions exhibits different patterns of attenuation at different interstimulus intervals, and 3) the extent of attenuation of the compression-induced hyperemia is proportional to the level of oxygenation achieved in the tissue. The results support the concept that tissue oxygenation is a key variable in blood flow regulation.
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Masamune, Ken, Atsushi Nishikawa, Toshikazu Kawai, Yuki Horise, and Noriyasu Iwamoto. "The development of Smart Cyber Operating Theater (SCOT), an innovative medical robot architecture that can allow surgeons to freely select and connect master and slave telesurgical robots." Impact 2018, no. 3 (June 15, 2018): 35–37. http://dx.doi.org/10.21820/23987073.2018.3.35.
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Master-slave robotic technology demonstrates a distinct model of communication that allows one device or user to have unidirectional control over one or more devices. The master refers to the user or device that initiates and controls the transmission, while the slave is the unit that receives these commands and acts accordingly. The direction of control always flows from the master to the slave. This technology has found a plethora of applications in a variety of fields such as engineering, information technology as well as hydraulic and pneumatic systems. Robotic technology has become an integral part of medical applications involving telesurgery (remote surgery) owing to the profound advantages it can offer to both surgeons and patience. Not only is surgery in previously-inoperable conditions now possible through this technology, but robotics also offer additional advantages in the training of medical professionals. In laparoscopic surgery, a high level of accuracy and control are required due to the complex nature and small scale of the area involved. Here, robotically-assisted surgery is performed by the surgeon using master-slave remotely-controlled manipulators or integrating locally-operated small surgical robots in a sterilised area. However, the fundamental problem associated with this master-slave system is that the master and the slave cannot be separated and exchanged with a master or a slave of another system. Performance of the robotic systems during these operations often come across limitations due to the inability of a slave robot to match the pace and performance of the master or the need for different tools during surgery, forcing a requirement for separate master-slave pairs. This creates an inefficiency in the system that Professor Ken Masamune from the Institute of Advance Biomedical Engineering and Science at the Tokyo Women’s Medical University seeks to address. By introducing a middleware that will connect these various masters and slaves, Masamune and his team seek to allow optimal communication and evaluation between robotic units. By separating the master from the slave and using middleware to allow communication between modules, the architecture being developed by Masamune, together with a group of collaborators, provides a quick evaluation of the master-slave combination and enables a far more efficient development and use of telesurgical robots.
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Quach, T., M. Abdelmonem, A. Nguyen, S. Yoshizuka, K. Vukic, W. Cai, E. Howard, and S. Kilambi. "Workflow Improvement after Implementing Remote Blood Allocation Devices at an Academic Medical Center Blood Bank." American Journal of Clinical Pathology 158, Supplement_1 (November 1, 2022): S160—S161. http://dx.doi.org/10.1093/ajcp/aqac126.341.
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Abstract Introduction/Objective Patients with hematological cancer routinely receive red blood cell (RBC) transfusions in the outpatient infusion clinical setting as part of their clinical therapy. Typically, RBCs are delivered to the outpatient infusion clinic via the pneumatic tube (P-tube). However, due to the recent expansion of the hospital footprint and the new location of the transfusion services, the P-tube encountered challenges that impacted the reliability of the delivery of RBC, which can delay patient care and affect patient satisfaction. This study’s purpose is to evaluate the pre-and post-implementation of the Haemobank-20 (HB20), remote blood storage and dispensing device, by reviewing the turn-around time (TAT) and the number of orders fulfilled outside of the transfusion service. Methods/Case Report Blood products are stocked to the HB in the infusion center. An electronic transfusion schedule is reviewed the night before scheduled transfusions to ensure appropriate inventory. When a patient is ready for the transfusion, the clinical nurse will use the device to retrieve blood products for the patient from the HB20. The average timed delivery time from the transfusion service to the outpatient infusion center is about 11 minutes. Data was retrospectively gathered from a 10-month interval before and after HB20 implementation to evaluate the number of orders fulfilled by the HB20. Results (if a Case Study enter NA) The HB has helped maintain nurse-to-patient ratios, reduced traffic at the blood bank issue window, and significantly sped up the turnaround time of RBCs from 11 minutes to less than 60 seconds. Before HB implementation, staff at the blood bank received 2853 units of RBCs through the blood bank window. This has been decreased by 61.2 percent to 1136 RBCs. Conclusion Implementing the Haemobank-20 in the outpatient infusion center has successfully reduced the turnaround time and the workload within the Transfusion Services. The current results study demonstrate that the remote blood-release system is safe and helpful in improving the efficiency of blood issue for patients in remote outpatient locations.
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Maessen-Visch, M. B., S. I. Langendoen, K.-P. de Roos, H. A. M. Neumann, and S. W. I. Reeder. "The recalcitrant venous leg ulcer – a never ending story?" Phlebologie 42, no. 06 (June 2013): 332–39. http://dx.doi.org/10.12687/phleb2145-6-2013.
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SummaryIntroduction: In general, four particular causes of recalcitrant venous leg ulcers may be distinguished. These are foot pump insufficiency, chronic venous compartment syndrome and non-re-canalized popliteal vein thrombosis. The fourth cause of recalcitrant venous leg ulcers is lipodermatosclerosis as a symptom of severe chronic venous insufficiency.Methods: We reviewed the literature and based on this we describe four main causes of recalcitrant venous leg ulcers and their specific treatment.Results: Foot pump insufficiency arises when the plantar foot veins are not able to empty. Treatment should consist of physical therapy, a mechanical foot pump device and an insole. Lipodermatosclerosis may be treated by excision and split-thickness skin grafting (Vigoni procedure). Chronic venous compartment syndrome is usually caused by post-thrombotic syndrome and treatment consists of a fasciectomy, but is rarely used nowadays. Patients with non-re-canalized popliteal vein thrombosis may be supported by intermittent pneumatic compression, walking exercises, alternate standing and walking with lying down. All patients with recalcitrant venous leg ulcers must wear medical elastic compression stockings with high stiffness and high compression lifelong.Conclusions: Patients with recalcitrant venous leg ulceration are challenging. More specific treatment will heal more of these ulcers.
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Cooper, David S., Jeffrey P. Jacobs, Lisa Moore, Arabela Stock, J. William Gaynor, Thomas Chancy, Michael Parpard, et al. "Cardiac extracorporeal life support: state of the art in 2007." Cardiology in the Young 17, S4 (September 2007): 104–15. http://dx.doi.org/10.1017/s1047951107001217.
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AbstractMechanical circulatory support is an invaluable tool in the care of children with severe refractory cardiac and or pulmonary failure. Two forms of mechanical circulatory support are currently available to neonates, infants, and smaller children, namely extracorporeal membrane oxygenation and use of a ventricular assist device, with each technique having unique advantages and disadvantages. The intra-aortic balloon pump is a third form of mechanical support that has been successfully used in larger children, adolescents, and adults, but has limited applicability in smaller children. In this review, we discuss the current experiences with extracorporeal membrane oxygenation and ventricular assist devices in children with cardiac disease.A variety of forms of mechanical circulatory support are available for children with cardiopulmonary dysfunction refractory to conventional management. These devices require extensive resources, both human and economic. Extracorporeal membrane oxygenation can be effectively used in a variety of settings to provide support to critically-ill patients with cardiac disease. Careful selection of patients and timing of intervention remains challenging. Special consideration should be given to children with cardiac disease with regard to anatomy, physiology, cannulation, and circuit management. Even though exciting progress is being made in the development of ventricular assist devices for long-term mechanical support in children, extracorporeal membrane oxygenation remains the mainstay of mechanical circulatory support in children with complex anatomy, particularly those needing rapid resuscitation and those with a functionally univentricular circulation.As the familiarity and experience with extracorporeal membrane oxygenation has grown, new indications have evolved, including emergent resuscitation. This utilization has been termed extracorporeal cardiopulmonary resuscitation. The literature supporting emergent cardiopulmonary support is mounting. Reasonable survival rates have been achieved after initiation of support during active compressions of the chest following in-hospital cardiac arrest. Due to the limitations of conventional circuits for extracorporeal membrane oxygenation, some centres have developed novel systems for rapid cardiopulmonary support.Many centres previously considered a functionally univentricular circulation to be a contraindication to extracorporeal membrane oxygenation, but improved results have been achieved recently with this complex subset of patients. The registry of the Extracorporeal Life Support Organization recently reported the outcome of extracorporeal life support used in neonates for cardiac indications from 1996 to 2000. Of the 740 neonates who were placed on extracorporeal life support for cardiac indications, 118 had hypoplastic left heart syndrome. There was no significant difference in survival between these patients and those with other defects. It is now common to use extracorporeal membrane oxygenation to support patients with a functionally univentricular circulation, and reasonable survival rates are to be expected.Although extracorporeal membrane oxygenation has become a standard of care for many paediatric centres, its use is limited to those patients who require only short-term cardiopulmonary support. Mechanical ventricular assist devices have become standard therapy for adults with cardiac failure refractory to maximal medical management. Several devices are readily available in the United States of America for adults, but there are fewer options available to children. Over the last few years, substantial progress has been made in paediatric mechanical support. Ventricular assist devices are being used with increasing frequency in children with cardiac failure refractory to medical therapy for primary treatment as a long-term bridge to recovery or transplantation. The paracorporeal, pneumatic, pulsatile “Berlin Heart” ventricular assist device is being used with increasing frequency in Europe and North America to provide univentricular and biventricular support. With this device, a patient can be maintained on mechanical circulatory support while extubated, being mobilized, and feeding by mouth.Mechanical circulatory support should be anticipated, and every attempt must be made to initiate support “urgently” rather than “emergently”, before the presence of dysfunction of end organs or circulatory collapse. In an emergency, these patients can be resuscitated with extracorporeal membrane oxygenation and subsequently transitioned to a long-term ventricular assist device after a period of stability.
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Flevas, Dimitrios A., Panayiotis D. Megaloikonomos, Leonidas Dimopoulos, Evanthia Mitsiokapa, Panayiotis Koulouvaris, and Andreas F. Mavrogenis. "Thromboembolism prophylaxis in orthopaedics: an update." EFORT Open Reviews 3, no. 4 (April 2018): 136–48. http://dx.doi.org/10.1302/2058-5241.3.170018.
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Venous thromboembolism (VTE) is a serious complication during and after hospitalization, yet is a preventable cause of in-hospital death. Without VTE prophylaxis, the overall VTE incidence in medical and general surgery hospitalized patients is in the range of 10% to 40%, while it ranges up to 40% to 60% in major orthopaedic surgery. With routine VTE prophylaxis, fatal pulmonary embolism is uncommon in orthopaedic patients and the rates of symptomatic VTE within three months are in the range of 1.3% to 10%. VTE prophylaxis methods are divided into mechanical and pharmacological. The former include mobilization, graduated compression stockings, intermittent pneumatic compression device and venous foot pumps; the latter include aspirin, unfractionated heparin, low molecular weight heparin (LMWH), adjusted dose vitamin K antagonists, synthetic pentasaccharid factor Xa inhibitor (fondaparinux) and newer oral anticoagulants. LMWH seems to be more efficient overall compared with the other available agents. We remain sceptical about the use of aspirin as a sole method of prophylaxis in total hip and knee replacement and hip fracture surgery, while controversy still exists regarding the use of VTE prophylaxis in knee arthroscopy, lower leg injuries and upper extremity surgery.Cite this article: EFORT Open Rev 2018;3:130-142. DOI: 10.1302/2058-5241.3.170018
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Tolentino Júnior, Dilceu Silveira, and Roberto Carlos de Oliveira. "Thromboprophylaxis Measures to Prevent Venous Thromboembolism in Hospitalized Patients." International Journal of Basic Science in Medicine 5, no. 4 (December 30, 2020): 118–24. http://dx.doi.org/10.34172/ijbsm.2020.21.
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Venous thromboembolism (VTE) is a serious complication in hospitalized patients and is the most frequent cause of preventable death in these patients, in addition to being the third cause of death of cardiovascular origin. Even though the loss of recent or continued mobility represents an important predisposition related to the onset of VTE, there are no clear and uniform criteria for defining the concept of immobility. Despite this, it is currently known that the early mobilization and other non-pharmacological thromboprophylactic measures of the patient in the medical or surgical clinic is an essential measure for his full recovery and satisfactory prognosis. Therefore, it is always important to prescribe preventive multiprofessional care, such as lateral decubitus variation, bed positioning, passive continuous movements apparatus as use of a cycle ergometer (CE), compressive socks, intermittent pneumatic compression (IPC), electric stimulation, sitting position, orthostatism, transfer from bed to chair, walking, and insertion of a filtering device in the lower portion of the main human vein in order to guarantee recovery quickly, safely and free from the risk of developing fatal complications such as pulmonary thromboembolism (PTE). Our objective in this article is to briefly summarize the main non-pharmacological thromboprophylaxis measures that help prevent venous embolism, in addition to addressing other mechanical resources used to prevent complications of thromboembolic events described in the literature on this topic.
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CALDWELL, DARWIN G., N. G. TSAGARAKIS, SOPHIA KOUSIDOU, NELSON COSTA, and IOANNIS SARAKOGLOU. ""SOFT" EXOSKELETONS FOR UPPER AND LOWER BODY REHABILITATION — DESIGN, CONTROL AND TESTING." International Journal of Humanoid Robotics 04, no. 03 (September 2007): 549–73. http://dx.doi.org/10.1142/s0219843607001151.
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The basic concepts for exoskeletal systems have been suggested for some time with applications ranging from construction, manufacturing and mining to rescue and emergency services. In recent years, research has been driven by possible uses in medical/rehabilitation and military applications. Yet there are still significant barriers to the effective use and exploitation of this technology. Among the most pertinent of these factors is the power and actuation system and its impact of control, strength, speed and, perhaps most critically, safety. This work describes the design, construction and testing of an ultra low-mass, full-body exoskeleton system having seven degrees of freedom (DOFs) for the upper limbs and five degrees of freedom (DOFs) for each of the lower limbs. This low mass is primarily due to the use of a new range of pneumatic muscle actuators as the power source for the system. The work presented will show how the system takes advantage of the inherent controllable compliance to produce a unit that is powerful, providing a wide range of functionality (motion and forces over an extended range) in a manner that has high safety integrity for the user. The general layout of both the upper and the lower body exoskeleton is presented together with results from preliminary experiments to demonstrate the potential of the device in limb retraining, rehabilitation and power assist (augmentation) operations.
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Kim, Soobin, Jessie Klugman, Sarah Norell, Alexandra Kenefake, Laurel Komos, Divya Jain, Moire Corcoran, et al. "Improving VTE prophylaxis adherence among hospitalized adolescents using Human-Centered Design." Journal of Patient Safety and Risk Management 26, no. 4 (July 2021): 172–78. http://dx.doi.org/10.1177/25160435211036784.
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Background/problem statement Venous thromboembolism (VTE) is the leading cause of preventable hospital mortality in the United States; however, compliance with VTE prophylaxis is poor. Most materials for education about VTE prophylaxis are oriented toward adults rather than adolescents, for whom VTE risks are lower and prophylaxis indications differ. We hypothesized that educational materials for adolescents could improve compliance with VTE prophylaxis, reduce nurse burden for initiating and maintaining VTE prevention practices, and reduce practice variation by standardizing the conversation between clinicians and patients. Methods A multidisciplinary team including physicians, nurses, quality experts, communication designers, service designers, and medical students applied a human-centered design (HCD) process to define, iteratively prototype, and test education tools for nurses assigned to adolescents. We piloted a suite of six educational tools for adolescent VTE prophylaxis to fit into the existing hospital workflow. Results An in-room poster was selected after 85% of nurses responded favorably to this intervention. Adolescent adherence with Intermittent Pneumatic Compression Device increased from 69% to 79%, attaining the benchmark goal of 78%. Staff reported greater confidence in educating adolescent patients after the intervention: 62% of nurses and 72% of residents. Conclusion An HCD process helped nurses improve VTE prophylaxis for adolescents with an in-room poster and messaging strategy. Engaging staff in the design increased receptivity and adoption. The piloted materials also helped to create an environment of shared priority among the clinicians.
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Visan, Alexandra Liana, and Nicolae Alexandrescu. "A Survey on the Evolution of Nonconventional Pneumatic Actuators." Advanced Materials Research 463-464 (February 2012): 1069–72. http://dx.doi.org/10.4028/www.scientific.net/amr.463-464.1069.
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In this article will be presented the evolution of the nonconventional pneumatic actuators, in general Pneumatic Artificial Muscles known in the technical literature as PAM’s that were patented as well as their main operating principles and area of activity. These types of actuators have been applied in all kinds of applications from mechanical engineering, robotic, alimentary industry, special equipments, diagnostic medical devices and prostheses.
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Antonelli, Michele Gabrio, Pierluigi Beomonte Zobel, Francesco Durante, and Terenziano Raparelli. "Additive Manufacturing Applications on Flexible Actuators for Active Orthoses and Medical Devices." Journal of Healthcare Engineering 2019 (March 24, 2019): 1–11. http://dx.doi.org/10.1155/2019/5659801.
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This paper describes the results of research projects developed at the University of L’Aquila by the research group of the authors in the field of biomedical engineering, which have seen an important use of additive manufacturing technologies in the prototyping step and, in some cases, also for the realization of preindustrialization prototypes. For these projects, commercial 3D printers and technologies such as fused deposition modelling (FDM) were used; the most commonly used polymers in these technologies are acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA). The research projects concern the development of innovative actuators, such as pneumatic muscles and soft pneumatic actuators (SPAs), the development of active orthoses, such as a lower limb orthosis and, finally, the development of a variable-stiffness grasper to be used in natural orifice transluminal endoscopic surgery (NOTES). The main aspects of these research projects are described in the paper, highlighting the technologies used such as the finite element analysis and additive manufacturing.
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Kresowik, Timothy F., David S. Nilasena, Anton F. Piskac, Rebecca A. Hemann, Marian A. Brenton, June M. Wilwert, Marc E. Hendel, and Lynnette E. Nevins. "Deep Vein Thrombosis Prophylaxis in Medicare Patients with Ischemic Stroke: Results from the National Stroke Project." Stroke 32, suppl_1 (January 2001): 337. http://dx.doi.org/10.1161/str.32.suppl_1.337.
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116 Background: Patients with ischemic stroke (IS) often have impaired mobility that can increase their risk of deep vein thrombosis (DVT). Current guidelines recommend prophylactic treatment for DVT in immobile IS patients. As part of HCFA’s National Stroke Project, we examined national patterns of DVT prophylaxis for Medicare patients hospitalized with IS. Methods: Project data were abstracted from a national sample of Medicare inpatient charts (discharge dates 4/98 - 3/99). All U.S. states, the District of Columbia and Puerto Rico were sampled using a systematic random approach. All medical records had a principal diagnosis of one of the following ICD-9-CM codes: 362.34, 433.xx, 434.xx, 435.0, 435.1, 435.3, 435.8, 435.9 or 436. Eligible cases had a confirmed diagnosis of IS and were non-ambulatory on the second hospital day. For DVT prophylaxis, we included the administration of warfarin or heparin (including low molecular weight), or the use of an intermittent pneumatic compression device (IPCD). Results: Of the 36,650 cases reviewed, 3,500 met the inclusion criteria. Nationwide, 694 (unadjusted rate 19.8%) had DVT prophylaxis initiated by the second hospital day. The data show that 75 (10.8%) patients utilized an IPCD, 602 (86.7%) were given warfarin, 36 (5.2%) received heparin and 19 (2.7%) utilized more than one form of DVT prophylaxis. Of the patients receiving warfarin for DVT prophylaxis, 263 (43.7%) were on warfarin prior to arrival. The state-specific rates of DVT prophylaxis utilization ranged from 7.8% to 33.3% (chi-square, p<0.001). Univariate analyses showed that DVT prophylaxis was utilized less frequently (p<0.002) for adults 85 years and over (rate=16.2%, OR=0.72, 95% CI=0.59–0.88) and African-Americans (rate=14.6%, OR=0.65, 95% CI=0.50–0.85). Conclusions: For non-ambulatory Medicare patients with IS, recommended prophylaxis for DVT is not given in the majority of cases. There is a large opportunity to improve this aspect of IS care and to reduce DVT as a complication of IS for non-ambulatory patients.
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Su, Hang, Xu Hou, Xin Zhang, Wen Qi, Shuting Cai, Xiaoming Xiong, and Jing Guo. "Pneumatic Soft Robots: Challenges and Benefits." Actuators 11, no. 3 (March 16, 2022): 92. http://dx.doi.org/10.3390/act11030092.
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In the field of robotics, soft robots have been showing great potential in the areas of medical care, education, service, rescue, exploration, detection, and wearable devices due to their inherently high flexibility, good compliance, excellent adaptability, and natural and safe interactivity. Pneumatic soft robots occupy an essential position among soft robots because of their features such as lightweight, high efficiency, non-pollution, and environmental adaptability. Thanks to its mentioned benefits, increasing research interests have been attracted to the development of novel types of pneumatic soft robots in the last decades. This article aims to investigate the solutions to develop and research the pneumatic soft robot. This paper reviews the status and the main progress of the recent research on pneumatic soft robots. Furthermore, a discussion about the challenges and benefits of the recent advancement of the pneumatic soft robot is provided.
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Urbankova, J., R. Quiroz, and S. Z. Goldhaber. "Intermittent pneumatic compression and deep vein thrombosis prevention in postoperative patients." Phlebology: The Journal of Venous Disease 21, no. 1_suppl (June 2006): 19–22. http://dx.doi.org/10.1258/026835506778243031.
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High incidence of venous thromboembolism (VTE) makes prophylaxis, screening and treatment extremely important. Both pharmacological and mechanical techniques can be used to reduce the risk of deep vein thrombosis (DVT). Mechanical methods have been studied much less intensively than pharmacological options. The principal mechanical methods of prophylaxis are graduated compression stockings and intemittent pneumatic compression devices. We conducted a meta-analysis of all randomized controlled trials to determine the effectiveness of intermittent pneumatic compression (IPC) devices in the preventon of DVT in post-surgical patients. The results of this analysis indicate that IPC devices reduced the risk of DVT by 60% when compared with patients with no mechanical or pharmacological prophylaxis. Contemporary randomized trials should be undertaken to test the utility of IPC in medcal patients as well as combined pharmacological plus IPC prophylaxis in both medical patients.
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Urbankova, Jana, Rene Quiroz, Nils Kucher, and Samuel Z. Goldhaber. "Intermittent pneumatic compression and deep vein thrombosis prevention." Thrombosis and Haemostasis 94, no. 12 (2005): 1181–85. http://dx.doi.org/10.1160/th05-04-0222.
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SummaryOur objective was to overview the effectiveness of intermittent pneumatic compression (IPC) devices to prevent deep vein thrombosis (DVT) in postoperative patients, using meta-analysis methodology. We searched the Medline, metaRegister of Controlled Trials, and Cochrane database for studies published between 1970 and October 2004. Our inclusion criteria were: 1) randomized controlled trial of IPC versus no prophylaxis, 2) at least 20 patients per group, 3) at least one diagnostic DVT imaging test in all patients, and 4) clinical follow-up for at least the duration of hospitalization. A total of 2,270 patients were included in 15 eligible studies: 1,125 and 1,145 in the IPC and no prophylaxis group, respectively. The included studies formed a total of 16 treatment groups and were conducted in orthopedic (5), general surgical (4), oncologic (3), neurosurgical (3) and urologic (1) patient populations. In comparison to no prophylaxis, IPC devices reduced the risk of DVT by 60% (relative risk 0.40, 95% CI 0.29 – 0.56; p< 0.001). Contemporary randomized trials should be undertaken to test the utility of IPC in hospitalized medical patients as well as combined pharmacological plus IPC prophylaxis in both medical and surgical patients.
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Kang, Sungwook, Hyunsoo Kim, Jaewoong Kim, Jong-Moon Hwang, Wonhee Lee, Jungtae Kim, and Hyunsu Ryu. "Noise Characteristics Analysis of Medical Electric Leg Compression Machine Using Multibody Dynamic Simulation." Applied Sciences 12, no. 8 (April 14, 2022): 3977. http://dx.doi.org/10.3390/app12083977.
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Conventional medical equipment used for treating patients with ischemic heart disease relies on pneumatic compression to achieve intense and instantaneous compression of the legs. Because the pneumatic operation of a compressor inevitably produces noise, the treatment is given to a patient in a separate room to avoid causing discomfort to other patients. This need for a dedicated treatment room could be another source of increased medical costs. In this study, a new electrical motor-driven system was developed to address the noise problem of existing pneumatic compression devices. Additionally, the new system features a reduced footprint and weight, and can be carried by medical staff. To develop a low-noise leg compression machine, the noise level at the surface of the structure was estimated using multibody dynamics simulation. Based on the initial design of the electric leg compression machine, parameters including assembly tolerance, component material, and shape of the structure were adjusted to prepare variations of the initial design, and their noise characteristics were analyzed. It was found that by applying the design variables, the noise levels were reduced by 7.2–11.7% compared with the initial design. The most significant reduction in noise levels was 11.7% and was achieved by reinforcing the section surrounding the gearbox enclosing a noise source.
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Karabegovic, Alen, Markus Hinteregger, Christoph Janeczek, Werner Mohl, and Margit Gföhler. "Closed-loop Helium Circulation System for Actuation of a Continuously Operating Heart Catheter Pump." International Journal of Artificial Organs 40, no. 6 (May 27, 2017): 272–81. http://dx.doi.org/10.5301/ijao.5000593.
Full textAbstract:
Background Currently available, pneumatic-based medical devices are operated using closed-loop pulsatile or open continuous systems. Medical devices utilizing gases with a low atomic number in a continuous closed loop stream have not been documented to date. This work presents the construction of a portable helium circulation addressing the need for actuating a novel, pneumatically operated catheter pump. The design of its control system puts emphasis on the performance, safety and low running cost of the catheter pump. Methods and results Static and dynamic characteristics of individual elements in the circulation are analyzed to ensure a proper operation of the system. The pneumatic circulation maximizes the working range of the drive unit inside the catheter pump while reducing the total size and noise production. Separate flow and pressure controllers position the turbine's working point into the stable region of the pressure creation element. A subsystem for rapid gas evacuation significantly decreases the duration of helium removal after a leak, reaching subatmospheric pressure in the intracorporeal catheter within several milliseconds. Conclusions The system presented in the study offers an easy control of helium mass flow while ensuring stable behavior of its internal components.
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UNSWORTH, A., I. HASLOCK, V. VASANDAKUMAR, and J. STAMP. "A LABORATORY AND CLINICAL STUDY OF PNEUMATIC ‘GRIP STRENGTH’ DEVICES." Rheumatology 29, no. 6 (1990): 440–44. http://dx.doi.org/10.1093/rheumatology/29.6.440.
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