COMPUTATION OF ELECTRIC FIELD IN TORSO OF CHILD

儿童躯干电场的计算

• 批准号: 8172260
• 负责人: Rob S. MacLeod
• 金额: $ 11.59万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-15 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8172260
• 关键词: Academic Medical Centers; Address; Adolescent; Adult; Algorithms; Anesthesiology; Boston; Cardiac; Cardiology; Child; Childhood; Cities; Clinical; Collaborations; Computer Retrieval of Information on Scientific Projects Database; Computer Simulation; Computer software; Data; Data Set; Defibrillators; Development; Devices; Drainage procedure; Electric Countershock; Elements; Engineering; Environment; Funding; Goals; Grant; Growth; Guidelines; Hospitals; Image; Imagery; Implant; Indium; Institution; Lead; Life; Magnetic Resonance Imaging; Measurement; Medical Imaging; Metric; Modeling; Orthopedics; Pain; Patients; Pediatric Hospitals; Physicians; Population; Research; Research Personnel; Resources; Shapes; Sodium Chloride; Software Tools; Source; Tissues; United States National Institutes of Health; base; bone; cost; electric field; experience; implantable device; implantation; insight; models and simulation; neonate; open source; psychologic; simulation; three-dimensional modeling; tool; wasting

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Placement of Implantable Cardiac Defibrillators (ICDs) in children is a unique and challenging problem due to the variety of shapes and sizes, ranging from neonate to adolescent, the need for anticipating growth, the cost of device replacement due to battery drainage, and the psychological intolerance of the device by this population. ICD placement in adults, while more routine, is also clearly suboptimal, producing wasted energy, increased pain levels, and reduced battery life. The result in children is an ad hoc array of device placement strategies, based on sparse experience and ignorant of biophysical principles. Although in many cases this approach is ultimately successful in as much as the result is clinically acceptable fibrillation protection, the lack of cohesive strategy leads to inefficient overall management. Moreover, when, in adults and children, a device implant fails, there are no robust guidelines to suggest alternatives and no tools to evaluate such alternatives. Finite element modeling has been shown in adult torso models to correlate well with clinical results but has not enjoyed use in the pediatric population. Nor has there emerged a generally validated software tool that clinicians can use to evaluate device placement options, neither before nor after implantation. Thus, the goal of this collaboration is to model defibrillation in child torso models to develop optimization strategies and software that could help physicians gain insight into this important problem. Dr. John Triedman at the Department of Cardiology, Children's Hospital Boston is the collaborative investigator of this project, assisted in the project by Dr. Matthew Jolley, now an anesthesiology resident at Stanford University Medical Center. The project also has local collaborative support through Drs. Elizabeth Saarel, Tom Pilcher, and Michael Puchalski, all from the Department of Cardiology at Primary Childrens' Hospital in Salt Lake City. The main clinical goal is thus to Determine strategies for optimal, patient specific lead and device placements of ICDs. From this clinical goal come three specific engineering aims of this project: (1) Create subject specific 3D models of children based on CT and MRI data sets for modeling internal and external defibrillation in the SCIRun environment; (2) Explore different metrics of successful defibrillation that can be derived from simulations of ICD placement; (3) Validate simulation results from clinical measurements. Technical progress in this project addresses the larger question of creating subject specific models that are based on medical imaging data and that include different tissue regions. The project will also drive the development of new algorithms, modules, and user interface elements in the SCIRun environment that will find application in other cases of image based modeling and simulation of electric fields (see description of the project on orthopedic bone implant stimulation for an example of how software created for cardiac defibrillation was directly useful for a dramatically different application). The project also represents part of an expanding collaboration between SCI (http://www.sci.utah.edu/) and SPL (http://splweb.bwh.harvard.edu:8000/), the goal of which is to create compatibility integrated open source tools for the creation, visualization, and computational simulation from image based, patient specific models.

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 植入式心脏除颤器（ICD）在儿童中的放置是一个独特而具有挑战性的问题， 形状和大小，从新生儿到青少年，预期生长的需要，设备的成本 由于电池耗尽导致的更换，以及该人群对器械的心理不耐受。 ICD置入 在成年人中，虽然更常规，但显然也不是最佳的，产生浪费的能量，增加疼痛水平，并减少 电池寿命 儿童的结果是基于稀疏经验的设备放置策略的特设阵列， 对生物物理学原理一无所知尽管在许多情况下，这种方法最终是成功的， 是临床上可接受的纤颤保护，缺乏连贯的策略导致低效的整体管理。 此外，当在成人和儿童中，装置植入失败时，没有强有力的指南来建议替代方案， 没有工具来评估这些替代方案。 有限元建模已被证明在成人躯干模型，以及相关的临床结果，但没有享受 在儿科人群中使用。 也没有出现一个普遍验证的软件工具，临床医生可以使用， 在植入前或植入后评价器械放置选项。 因此，这项合作的目标是在儿童躯干模型中模拟除颤，以制定优化策略， 可以帮助医生深入了解这一重要问题的软件。 约翰·特里德曼博士在 波士顿儿童医院心脏科是该项目的合作研究者，由Dr。 马修·乔利现在是斯坦福大学医学中心的麻醉科住院医师。 该项目也有当地 伊丽莎白·萨雷尔博士，汤姆·皮尔彻博士和迈克尔·普查尔斯基博士的合作支持，他们都来自卫生部。 湖城初级儿童医院的心脏病学。 因此，主要临床目标是确定ICD的最佳、患者特定电极导线和器械放置策略。 从该临床目标中得出本项目的三个具体工程目标： (1)基于CT和MRI数据集创建儿童的特定对象3D模型，用于内部和外部建模 SCIRun环境中的除颤; (2)探索成功除颤的不同指标，这些指标可以从ICD放置模拟中得出; (3)从临床测量中获得模拟结果。 该项目的技术进展解决了创建基于以下主题的特定模型的更大问题： 医学成像数据并且包括不同的组织区域。 该项目还将推动新的 算法，模块和用户界面元素在SCIRun环境中，将发现在其他情况下的应用， 基于图像的电场建模和模拟（参见矫形骨植入物项目描述 刺激的例子，为心脏除颤创建的软件是如何直接用于显着 不同的应用）。 该项目也是SCI（http：//www.sci.utah.edu/）和SPL之间不断扩大的合作的一部分 (http：//splweb.bwh.harvard.edu：8000/），其目标是为 从基于图像的患者特定模型创建、可视化和计算模拟。