title: Decentralized safety concept for closed-loop controlled intensive care.
abstract: This paper presents a decentralized safety concept for networked intensive care setups, for which a decentralized network of sensors and actuators is realized by embedded microcontroller nodes. It is evaluated for up to eleven medical devices in a setup for automated acute respiratory distress syndrome (ARDS) therapy. In this contribution we highlight a blood pump supervision as exemplary safety measure, which allows a reliable bubble detection in an extracorporeal blood circulation. The approach is validated with data of animal experiments including 35 bubbles with a size between 0.05 and 0.3 ml. All 18 bubbles with a size down to 0.15 ml are successfully detected. By using hidden Markov models (HMMs) as statistical method the number of necessary sensors can be reduced by two pressure sensors.
authors.affiliation: Informatik 11 - Embedded Software, RWTH Aachen University, 52056 Aachen.
authors.forename: Jan
authors.initials: J
authors.lastname: Kühn
authors.affiliation: Philips Chair for Medical Information Technology, RWTH Aachen University, 52056 Aachen.
authors.forename: Christian
authors.initials: C
authors.lastname: Brendle
authors.affiliation: Informatik 11 - Embedded Software, RWTH Aachen University, 52056 Aachen.
authors.forename: André
authors.initials: A
authors.lastname: Stollenwerk
authors.affiliation: Informatik 11 - Embedded Software, RWTH Aachen University, 52056 Aachen.
authors.forename: Martin
authors.initials: M
authors.lastname: Schweigler
authors.affiliation: Informatik 11 - Embedded Software, RWTH Aachen University, 52056 Aachen.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kowalewski
authors.affiliation: Department of Intensive Care and Intermediate Care, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Janisch
authors.affiliation: Department of Anesthesiology, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen.
authors.forename: Rolf
authors.initials: R
authors.lastname: Rossaint
authors.affiliation: Philips Chair for Medical Information Technology, RWTH Aachen University, 52056 Aachen.
authors.forename: Steffen
authors.initials: S
authors.lastname: Leonhardt
authors.affiliation: Philips Chair for Medical Information Technology, RWTH Aachen University, 52056 Aachen.
authors.forename: Marian
authors.initials: M
authors.lastname: Walter
authors.affiliation: Department of Intensive Care and Intermediate Care, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen.
authors.forename: Rüdger
authors.initials: R
authors.lastname: Kopp
mesh_terms: D000818:Animals; D056902:Clinical Alarms; D003422:Critical Care / Q000379:methods*; D005112:Extracorporeal Circulation / Q000379:methods*; D025461:Feedback, Physiological; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D061214:Patient Safety; D010363:Pattern Recognition, Automated / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: ARDS; ECMO; blood pump; bubble detection; decentralized supervision; distributed systems; fault detection; hidden Markov models