Towards the design and implementation of a human circulatory system for Extracorporeal Membrane Oxygenation simulation
Towards the design and implementation of a human circulatory system for Extracorporeal Membrane Oxygenation simulation
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体外膜氧合模拟人体循环系统的设计和实现
DOI：
10.1016/j.ejccm.2018.12.017
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
I. Hassan
中科院分区：
文献类型：
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作者：
U. Khurshid;A. Mahmoud;Aiman Abducarim;S. Mahmud;Omrane Abdallah;Elshaikh Mohamed;F. Bensaali;A. Amira;A. Alsalemi;Ali Ait Hssain;Guillaume Alinier;I. Hassan
体外膜氧合（ECMO）是为短期呼吸和/或心脏问题患者的护理开发的一种挽救生命的程序（MacLaren et al., 2011）。ECMO患者必须由ECMO训练的多学科团队每天24小时监测。训练有素的医疗保健专业人员需要观察50多个变量，并迅速干预以评估和解决任何给定的紧急情况。因此，动手培训对于ECMO专业人员在不同情况下发展快速和正确的行动非常重要。基于模拟的培训（SBT）为ECMO从业者提供了一个机会，可以发展启动ECMO程序和护理ECMO患者所需的技能，而不会使患者面临不必要的风险（Al Disi等人，2018）。为了使ECMO起作用，需要插管使血液重新流向机器，而不是肺部和/或心脏。插管是将导管插入血管。与卡塔尔主要的医疗保健提供商哈马德医疗公司（HMC）合作，该项目的目标是开发一种有效、经济实用、用户友好、低成本和多功能高保真的插管模拟人体模型。体外膜氧合（ECMO）是一种用于治疗短期呼吸和/或心脏问题患者的救命方法。ECMO患者必须由ECMO训练的多学科团队每天24小时监测。训练有素的医疗保健专业人员需要观察50多个变量，并迅速进行干预，以评估和解决任何给定的紧急情况。因此，对于ECMO从业者来说，实践培训非常重要，以发展快速和正确的行动来应对不同的潜在情况。基于模拟的培训（SBT）为ECMO从业者提供了一个机会，以发展启动ECMO程序和护理ECMO患者所需的技能，而不会使他们暴露于过度的风险中。为了使ECMO起作用，需要插管使血液重新流向机器，而不是肺部和/或心脏。插管是将导管插入血管。与卡塔尔主要的医疗保健提供者哈马德医疗公司（HMC）合作，该项目的目的是开发一种有效、经济、实用、用户友好、低成本和多功能的插管训练器。所提出的ECMO模拟器，如图1所示，由两个子系统组成：(a) ECMO训练生态系统；(b)插管训练师。第一个子系统正在由另一组研究人员开发，并已进入最后阶段。它包括一个热致变色回路，一种创新的血液颜色模拟机制[3,4]，以及用于模拟ECMO电路并发症的模拟模块[5,6]。该系统可以经济有效地模拟大量的ECMO训练场景，具有高水平的真实感（例如低氧血症，线路抖动，电源故障，泵故障等）。教师可以通过创新的平板电脑应用程序来指导学习体验，该应用程序可以实时控制各种ECMO模拟模块和标准化学习课程的程序场景[7-9]。然而，模拟器并没有关注人体/人体模型的底层系统。这项工作描述了第二个子系统，其重点是模拟人体的不同功能，例如从心脏向器官泵血，以及插管过程和过程中发生的风险。重点介绍了热致变色油墨闭环系统的设计、构造及使用方法。
Extracorporeal Membrane Oxygenation (ECMO) is a lifesaving procedure developed for the care of patients with short-term respiratory and/or cardiac issues (MacLaren et al., 2011). ECMO patients must be monitored twenty-four hours a day by an ECMO-trained multidisciplinary team. The trained healthcare professional needs to watch over fifty variables and rapidly intervene to assess and resolve any given emergency. Hence hands on training is very important for ECMO professionals to develop rapid and correct actions upon different scenarios. Simulation based training (SBT) offers ECMO practitioners an opportunity to develop the skills needed for the initiation of the ECMO procedure and the care of ECMO patients without exposing patients to undue risks (Al Disi et al., 2018). For ECMO to work, cannulation is required to reroute the blood flow to the machine rather than the lung and/or heart. Cannulation is the insertion of a cannula through the blood vessels. In collaboration with Hamad Medical Corporation (HMC), the main healthcare provider in Qatar, the aim of this project is to develop an effective, economical realistic, user-friendly, low-cost, and a multi-functional high-fidelity cannulation simulation mannequin.1. BackgroundExtracorporeal Membrane Oxygenation (ECMO) is a lifesaving procedure developed for the care of patients with short-term respiratory and/or cardiac issues [1]. ECMO patients must be monitored twenty-four hours a day by an ECMO-trained multidisciplinary team. The trained healthcare professionals need to watch over fifty variables and rapidly intervene to assess and resolve any given emergency. Hence hands-on training is very important for ECMO practitioners to develop rapid and correct actions to respond to different potential situations. Simulation-based training (SBT) offers ECMO practitioners an opportunity to develop the skills needed for the initiation of the ECMO procedure and the care of ECMO patients without exposing them to undue risks [2]. For ECMO to work, cannulation is required to reroute the blood flow to the machine rather than the lung and/or heart. Cannulation is the insertion of a cannula through the blood vessels. In collaboration with Hamad Medical Corporation (HMC), the main healthcare provider in Qatar, the aim of this project is to develop an effective, economical, realistic, user-friendly, low-cost, and multi-functional cannulation trainer.2. MethodsThe proposed ECMO simulator, as illustrated in Fig. 1, consists of two sub-systems:(a) ECMO training eco-system; and (b) Cannulation trainer. The first sub-system is being developed by another group of researchers and is in its final stage. It encompasses a thermochromic loop, an innovative blood color simulation mechanism [3, 4], and simulation modules developed to simulate ECMO circuit complications [5, 6]. The system can cost-effectively simulate a plethora of ECMO training scenarios with a high level of realism (eg hypoxemia, line chattering, power failure, pump failure, etc.). Instructors can steer the learning experience through an innovative tablet application that enables real-time control of various ECMO simulation modules and program scenarios for standardized learning sessions [7–9]. However, the simulator did not focus on the underlying system in the body/mannequin. This work describes the second sub-system which focuses on the emulations of the different functions of the human body such as the pumping of blood from heart to the organs, along with the cannulation procedure and the risks occurred during the procedure. The focus is mainly on the design and the construction of a closed-loop system with thermochromic ink and the usage …