This document outlines the components and development of clinical perfusion data (CPD) used during cardiopulmonary bypass procedures. It discusses how CPD has evolved from handwritten records to computerized databases to better organize patient information, physiological parameters, blood gas results, and perfusionist details. Maintaining complete and accurate CPD is important for documenting the surgical procedure, monitoring patient safety, and complying with legal and regulatory standards. The presentation concludes by demonstrating the current computerized CPD database system used at this medical center.
Perioperativebloodtransfusionsarecostlyandhavesafetyconcerns.Asa result, there have been multiple initiatives to reduce transfusion use. However, the degree to which perioperative transfusion rates vary among hospitals is unknown.
Objective Toassesshospital-levelvariationinuseofallogeneicredbloodcell(RBC), fresh-frozen plasma, and platelet transfusions in patients undergoing coronary artery bypass graft (CABG) surgery.
The main objective of this project is to measure the heart pumping function continuously and with maximally non-invasive methodology in a medical setting arrangement. Thus this paper is aimed to determine the study of impedance plethysmographic method to evaluate the stroke volume changes. In this paper the blood flow analysis has been carried out with fuzzy logic tool box with various activities such as Dehydration, Physical exercise, Cool skin, Warm Skin and breathes hold activity. Immediately after measuring the blood flow with the help of Impedance plethysmography, the end systolic and end diastolic values are obtained with the help of echocardiogram for the 18 subjects both in the normal condition and immediately after holding the breathe for 25 seconds. For the 18 subjects the correlation coefficient is obtained in a linear fashion between the changes in peak amplitude of forearm impedance plethysmographic waveform and changes in stroke volume before and after the 25 second breathe holding activity. Finally the forearm impedance plethysmographic waveform can be used to analyze the heart beat changes in Correlation with the changes in heart stroke volume. The process could be monitored for the series of cycles in determining the heart pumping performance.
Perioperativebloodtransfusionsarecostlyandhavesafetyconcerns.Asa result, there have been multiple initiatives to reduce transfusion use. However, the degree to which perioperative transfusion rates vary among hospitals is unknown.
Objective Toassesshospital-levelvariationinuseofallogeneicredbloodcell(RBC), fresh-frozen plasma, and platelet transfusions in patients undergoing coronary artery bypass graft (CABG) surgery.
The main objective of this project is to measure the heart pumping function continuously and with maximally non-invasive methodology in a medical setting arrangement. Thus this paper is aimed to determine the study of impedance plethysmographic method to evaluate the stroke volume changes. In this paper the blood flow analysis has been carried out with fuzzy logic tool box with various activities such as Dehydration, Physical exercise, Cool skin, Warm Skin and breathes hold activity. Immediately after measuring the blood flow with the help of Impedance plethysmography, the end systolic and end diastolic values are obtained with the help of echocardiogram for the 18 subjects both in the normal condition and immediately after holding the breathe for 25 seconds. For the 18 subjects the correlation coefficient is obtained in a linear fashion between the changes in peak amplitude of forearm impedance plethysmographic waveform and changes in stroke volume before and after the 25 second breathe holding activity. Finally the forearm impedance plethysmographic waveform can be used to analyze the heart beat changes in Correlation with the changes in heart stroke volume. The process could be monitored for the series of cycles in determining the heart pumping performance.
Pre-operative anaemia is present in approximately 30% of patients undergoing noncardiac surgery [1]. The presence of pre-operative anaemia is the strongest predictor of perioperative blood transfusion and is an independent risk factor for post-operative morbidity and mortality [2]. It is well known that Red Blood Cells (RBC) transfusion can increase the surgical length of stay, increase mortality in surgical patients, and expose patients to the risk of circulatory overload, acute lung injury, and immunosuppression [3-5]. Sufficient data exist to support intravenous iron as efficacious and safe. Intravenous iron should be used as front-line therapy in patients who do not respond to oral iron or are not able to tolerate it, or if surgery is planned for <6 weeks after the diagnosis of iron deficiency [6]. The European Medicines Agency concluded that the benefits of i.v. iron exceed the risks when used appropriately (correct indication and dose), without any difference in safety profile among available formulations [7]. We report two vascular cases had peri-operative i.v iron treatment for anaemia.
Presentación del Dr. Josep Redón i Mas, del Hospital Clínico Universitario de Valencia, durante la I Reunión de Denervación Renal de la Sección de Hemodinámica y Cardiología Intervencionista (SHCI) de la Sociedad Española de Cardiología (SEC), celebrada del 29 al 30 de enero de 2014.
Papua New Guinea has about seven active mining and exploration activities for minerals like gold, copper, and other minor minerals. Each is managed by different company and
together employs about ten thousand workers. A fifth of this would be foreign workers. Most of the Mine workers that are screened at the Employees Health and Wellness clinics tend to
have similar compounding health risks
Cardiology
From Wikipedia, the free encyclopedia
Jump to navigationJump to search
This article is about the medical specialty. For the album, see Cardiology (album). For the medical journal, see Cardiology (journal).
Cardiology
Heart diagram blood flow en.svg
Blood flow diagram of the human heart. Blue components indicate de-oxygenated blood pathways and red components indicate oxygenated blood pathways.
System Cardiovascular
Subdivisions Interventional, Nuclear
Significant diseases Heart disease, Cardiovascular disease, Atherosclerosis,
earning websites that make the most money
Advances in Automated CPR
A/Prof Marcus Ong
Consultant, Senior Medical Scientist
& Director of Research
Department of Emergency Medicine
Singapore General Hospital
The OCS, another revolution to the medical sciences keeps a disconnected organ for transplantation in straight for a more drawn out term in consideration and dynamic.The device allows the vital organs like heart and lungs to stay warm and functioning outside the body.
Pre-operative anaemia is present in approximately 30% of patients undergoing noncardiac surgery [1]. The presence of pre-operative anaemia is the strongest predictor of perioperative blood transfusion and is an independent risk factor for post-operative morbidity and mortality [2]. It is well known that Red Blood Cells (RBC) transfusion can increase the surgical length of stay, increase mortality in surgical patients, and expose patients to the risk of circulatory overload, acute lung injury, and immunosuppression [3-5]. Sufficient data exist to support intravenous iron as efficacious and safe. Intravenous iron should be used as front-line therapy in patients who do not respond to oral iron or are not able to tolerate it, or if surgery is planned for <6 weeks after the diagnosis of iron deficiency [6]. The European Medicines Agency concluded that the benefits of i.v. iron exceed the risks when used appropriately (correct indication and dose), without any difference in safety profile among available formulations [7]. We report two vascular cases had peri-operative i.v iron treatment for anaemia.
Presentación del Dr. Josep Redón i Mas, del Hospital Clínico Universitario de Valencia, durante la I Reunión de Denervación Renal de la Sección de Hemodinámica y Cardiología Intervencionista (SHCI) de la Sociedad Española de Cardiología (SEC), celebrada del 29 al 30 de enero de 2014.
Papua New Guinea has about seven active mining and exploration activities for minerals like gold, copper, and other minor minerals. Each is managed by different company and
together employs about ten thousand workers. A fifth of this would be foreign workers. Most of the Mine workers that are screened at the Employees Health and Wellness clinics tend to
have similar compounding health risks
Cardiology
From Wikipedia, the free encyclopedia
Jump to navigationJump to search
This article is about the medical specialty. For the album, see Cardiology (album). For the medical journal, see Cardiology (journal).
Cardiology
Heart diagram blood flow en.svg
Blood flow diagram of the human heart. Blue components indicate de-oxygenated blood pathways and red components indicate oxygenated blood pathways.
System Cardiovascular
Subdivisions Interventional, Nuclear
Significant diseases Heart disease, Cardiovascular disease, Atherosclerosis,
earning websites that make the most money
Advances in Automated CPR
A/Prof Marcus Ong
Consultant, Senior Medical Scientist
& Director of Research
Department of Emergency Medicine
Singapore General Hospital
The OCS, another revolution to the medical sciences keeps a disconnected organ for transplantation in straight for a more drawn out term in consideration and dynamic.The device allows the vital organs like heart and lungs to stay warm and functioning outside the body.
Value Analysis Committee Presentation (Branded) - PleuraFlow® ACT® SystemPaul Molloy
Presentation explaining how the PleuraFlow® ACT® System from ClearFlow,Inc.can Reduce Complications and Costs for your Cardiothoracic surgery patients.
Endovascular and surgical treatment of pulmonary embolism 26.11.17Ivo Petrov
Interventional treatment (thrombus fragmentation and supraselective fibrinolysis) of high and intermediate risk patients with pulmonary embolism.
Protocols of intervention, results, clinical cases provided
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Cardiac conduction defects can occur due to various causes.
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Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. 1. Introduction
2. Definition of Clinical Perfusion Data
3. Development in Our Setting
4. Components of CPD
5. Conclusion
6. Short Demonstration
OUTLINE
3. WHAT IS A PERFUSIONIST ?
PERFUSIONISTS
Operate the heart lung machine,
Monitoring and controlling oxygen
levels, blood pressure, body
temperature and blood flow.
They also administer anesthetics and
other drugs during surgery.
(Prof. Michael Smith
Quinnipiac University School of Health Sciences)
4. Perfusion data is one of the major standards
recommendations of monitoring during
cardiopulmonary bypass (CPB).
(Society of Clinical Perfusion Scientists
of Great Britain & Ireland, 2007)
This includes monitoring for the onset of and
weaning from CPB,
confirmation of anticoagulation
and ventilation of the lungs.
(Association of Cardiothoracic Anesthetics & Society for Cardiothoracic Surgeon in Great Britain &
Ireland, 2007)
INTRODUCTION
5. Perfusion data can defined as:
The perfusion record (written or electronic) for
each (CPB) procedure
which shall be included as part of patient’s
permanent medical record.
(American Society of ExtraCorporeal Technology, 2013)
…..is a legal presentation of the procedure,
whether manually recorded or computerized
which should be maintained & stored
in patient's notes, according to institution policy
for retaining medical records.
(Society of Clinical Perfusion Scientists
of Great Britain & Ireland, 2007)
WHAT IS CLINICAL PERFUSION DATA (CPD)?
6. DEVELOPMENT IN OUR SETTING:
HANDWRITTEN CLINICAL PERFUSION DATA
DISADVANTAG
ES
Difficult in
storage –
filing system
Bad Hand
writing
Searching gets
difficult as the
filing gets more.
1996
till
1998
8. COMPUTERISED CLINICAL PERFUSION DATA
( EXCEL) … CONTINUE
DISADVANTAGES
Big files required
more Hard-disk
space
Takes a long time
for searching data
Not able to keep
data in sequent
format
Difficult to track such as:
- number of pump run by
perfusionist
- number of case
in respective
groups
- difficult to compile Data
as each OT’s has got
individual PCs
9. OUR DEVELOPMENT: COMPUTERISED
CLINICAL PERFUSION DATA (DATABASE)
Database records are
divided into fields,
which makes searching
the databases easier.
What goes into each
field varies depending
on the type of literature
we’re documenting.
ADVANTAGES
- Easier to key in data
- Searching made
simpler and faster
- Well organized data
no matter how long the
files are.
18. COMPONENT OF CPD
1. Patient information
(demographics & pre-operative risk factors).
2. Information describing :-
(procedure, personnel & equipment ).
3. Patient physiology parameters
(documented at a frequency determined by institutional protocol).
4. Blood gas & anticoagulation monitoring results.
5. Signature of the perfusionist (include relief).
(American Society of ExtraCorporeal Technology, 2013)
19. 1. PATIENT INFORMATION, DEMOGRAPHICS &
PRE-OPERATIVE RISK FACTORS
Perfusion Record: Includes Single Entry Information
Medical Record Number ( RN).
Patient Name.
Demographics. ( Age, Gender, Height , Weight, Body
Surface Area (BSA)
Laboratory Data. ( Hematocrit, Predicted Hematocrit on Bypass)
Patient Allergies.
Planned Procedure.
Medical History/ Risk Factors. (Cardiovascular, Renal, Neurologic, GI Track).
1
20. 2. INFORMATION DESCRIBING PROCEDURE,
PERSONAL & EQUIPMENT
Perfusion Record:
Includes Single Entry And Recorded Lot Number.
Record Lot Number
Equipment –
Heart Lung Machine
Disposables:
- Oxygenator
- Tubing pack/
Arterial Line Filter
- Centrifugal Pump Head
- Ultrafiltration Device
- Arterial & Venous Cannulae
Single Entry
• Date of Procedure
• Type of Procedure
• Perfusionist’s Name
• Surgeon’s Name
• Anaesthesiologist's Name
• Nurse’s Name
• Operating Room Name
• Comments/Events
2
24. 4. BLOOD GAS & ANTICOAGULATION
MONITORING RESULTS
Perfusion Record:
Includes Multiple Entry Information For Laboratory
Values At Least Every 30 Minutes
Arterial or venous blood Gases
Venous Oxygen Saturation
Potassium Concentration
Haemoglobin /Haematocrit
Anticoagulation monitoring - Activated Clotting Times
(ACT) and/or Heparin level.
26. 4. BLOOD GAS & ANTICOAGULATION
MONITORING RESULTS…CONTINUE
Perfusion Record:
Includes Intermittent Information Entry At
Appropriate Time
Input fluid volumes – Blood Product
– Prime fluids
– Fluid Added
Output fluids – Urine output
– Ultrafiltration
Perfusionist Administered Medication
4
27.
28. 5. SIGNATURE OF THE PERFUSIONIST
Signature of the perfusionist
(and all relief perfusionists) performing
the procedure.
Include the signature of physician(s) providing
supervision for the CPB procedure.
5
29. 21/9/2013 29
It is the responsibility of the clinical perfusionist to assist the
Surgeon/physician in any way possible in patient care
& particularly within the defined areas of expertise
of the clinical perfusionist ….
(The American Academy of Cardiovascular Perfusion, 2008)
CONCLUSION
31. REFERENCES:
Banbury, M.,White J., Blackstone, E., & Cosgrovo, D. (2003)Vacuum-assisted venous return reduces blood usage. Journal
ofThoracic Cardiovascular Surgery.Vol. 126 (3), pp:680-687.
Jegger, D.,Tevaearai, H.T., Mueller, X.M., Horisberger, J., & von Segesser, LK. (2003).
Limitations using the vacuum-assist venous drainage technique during cardiopulmonary
bypass procedures. The Journal Of Extra-corporealTechnology. Vol. 35 (3), pp: 207 – 211.
Munster, K., Anderson, U., Mikkelsen, J., & Petterson,G.(1999).Vacuum AssistedVenous Drainage
(VAVD). University of Copenhagen and Hamlet Private Hospital.
Vol. 14 (6), pp: 419 – 423.
Shigang Wang & Akif Undar (2009). Vacuum-assisted venous drainage and gaseous microemboli in
pulmonary bypass. The Journal Of Extra-corporealTechnology. Vol. 40 (4), pp: 249 – 256.
Sintya,T. et al. (2011). Vacuum-assisted venous drainage in cardiopulmonary bypass and need of blood transfusion:
experience of service. Brazilian Journal of Cardiovascular Surgery.Vol. 26 (1).
Willcox,T. (2013).Vacuum Assist:Angel or Demon CON. The Journal Of Extra-corporeal
Technology. Vol. 45 (2), pp: 128 – 141.
Willcox,T. (2002).Vacuum-assisted venous drainage: to air or not to air, that is the question.
Has the bubble burst? The Journal Of Extra-corporealTechnology. Vol. 34, pp: 24–28.
Y Hayashi et al. (2001). Clinical application of vacuum-assisted cardiopulmonary bypass with a pressure
relief valve. European Journal of Cardio-Thoracic Surgery.Vol. 20 (3), pp: 621 - 627. .
21/9/2013 31
32.
33. GET SOME CHAT SLIDES READY in
case the video doesn’t work