International Research Journal of Engineering and Technology (IRJET) e-ISSN: 2395 -0056 Volume: 04 Issue: 02 | Feb -2017
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p-ISSN: 2395-0072
An INTELLIGENT SYSTEM for PATIENT MONITORING & CLINICAL DECISION SUPPORT IN NEURO-CRITICAL-CARE S.N. Shinde1, J.V. Kulkarni2, V.M. Mohite3, A.G. Kshirsagar4 Assistant Professor, SETI, Panhala11 UG Student, SETI PANHAL 2, 4, 3 ---------------------------------------------------------------------***---------------------------------------------------------------------
Abstract - Acute monitoring and timely treatment are extremely crucial in Neuro Intensive/Critical Care Units (NICUs) to prevent patients from secondary brain damages. So we developed an integrated and intelligent system to enhance the effectiveness of patient monitoring and clinical decision makings in NICUs. The requirements of the system were investigated through interviews and discussions with neurosurgeons, neuroclinicians and nurses. Based on the summarized requirements stem is developed. This system integrates and stores crucial patient information ranging from demographic details, clinical & treatment records to continuous physiological monitoring data. This system enables remote and centralized patient monitoring and provides computational intelligence to facilitate clinical decision makings.
Key Words: Microcontroller, PC (VB), Power supply 1.INTRODUCTION Neurocritical care or neurointensive care is a branch of medicine that emerged in the 1980’s and deals with lifethreatening diseases of the nervous system, which are those that involve the brain, spinal cord and nerves. The Neurocritical Care Society was founded in San Francisco in 2002 to promote quality patient care, professional collaboration, research, training, education with the goal of improving outcomes for patients with life threatening neurologic diseases. The doctors who practice this type of medicine are called neurointensivists, and can have medical training in many fields, including neurology, anesthesiology, or neurosurgery. Most neurocritical care units are collaborative effort between neurointensivists, neurosurgeons, neurologists, radiologists, pharmacists, physician extenders (such as nurse practitioners or physician’s assistants),critical care nurses, respiratory therapists, and social workers who all work together in order to provide coordinated care for the critically ill neurologic patient. Common diseases treated in neurointensive are units include strokes, brain and spinal cord injury from trauma, seizures, swelling of the brain, © 2017, IRJET
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infections of the brain, brain tumors, and weakness of the muscles required to breathe. The modern intensive care units (ICUs) typically employ continuous hemodynamic monitoring (e.g., heart rate (HR) and invasive arterial BP measurements) to track the state of patients. Hemodynamic instability is most commonly associated with abnormal or unstable blood pressure (BP), especially hypotension, or more broadly associated with inadequate global or regional perfusion. [4]. Patients in Neuro Intensive/Critical Care Units (NICUs) often suffers from certain levels of brain damage. Some of the patients who now survive severe head injury due to intensive therapy in the acute stage make a satisfactory recovery. [7] The major challenge in patient monitoring and treatment in NICUs is that the primary brain damage is often compounded by secondary damages that occur during the patient’s stay in NICUs [1]. The secondary brain damage, formally known as “the secondary insult”, can be caused by intracranial hypertension or insufficient oxygen and nutrition supple to the brain. Secondary insults can potentially be reduced and prevented with the help of continuous patient monitoring and timely treatments. [5].[6]In the current NICU practice, patient monitoring & treatment mainly rely on manual inspections and experience- based judgments from clinicians and nurses. The current approach is labor-intensive, prone to human errors and ineffective. To address this, we developed an integrated and intelligent system to enhance the effectiveness of patient monitoring and clinical decision makings in NICUs. The system is named as an intelligent System for Neuro-CriticalCare. This system provides an integrated platform that gathers a wide spectrum of patient information, which includes demographic data, clinical records, continuous treatment records and multi-modal physiological monitoring data. Based on the integrated data, this system analyses and forecasts patients’ changing physiological status and generates alerts for impending changes of the status. In addition, this system also predicts patients’ recovery outcome, which serves as a reference for clinical decision makings. Management of intracranial pressure (ICP) following a traumatic brain injury (TBI) is an essential aspect of minimizing such secondary brain injuries as intracranial
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