RESUMO
OBJECTIVE: Peripheral vascular disease is a worldwide leading health concern. Real-time peripheral hemoperfusion monitoring during treatment is essential to plan treatment strategies to improve circulatory enhancement effects. METHODS: The present work establishes a Janus flexible perfusion (JFP) sensor system for dynamic peripheral hemoperfusion monitoring. We develop a Janus structure design with different Young's modulus to improve the mechanical properties for motion artifacts suppression. Besides, we propose a peripheral perfusion index (PPI) to assess the peripheral hemoperfusion based on an optical perfusion model that is experimentally verified using an in-vitro model. The effectiveness of the system is assessed in three experimental scenarios, including motion artifact-robust test, induced vascular occlusion in upper limb, and peripheral hemoperfusion monitoring with the treatment of intermittent pneumatic compression (IPC), with comparison with Laser Doppler flowmetry (LDF). RESULTS: The noise level of the traditional rigid sensor is five times that of the JFP sensor within the effective signal frequency domain when there is movement. The PPI can effectively discriminate between different peripheral hemoperfusion states and has a correlation coefficient of 0.92 with the LDF mean values. The kappa statistic between the JFP sensor and LDF is 0.78, indicating substantial agreement between them to estimate the peripheral hemoperfusion improvements during IPC treatment. CONCLUSION: The sensor system we proposed can monitor peripheral hemoperfusion variation in real-time and is insensitive to motion artifacts. SIGNIFICANCE: The proposed sensing system provides a functional module for real-time estimation of peripheral hemoperfusion during clinical interventions.
RESUMO
<p><b>OBJECTIVE</b>To study the effect of Shenmai Injection (SMI) on the clinical efficacy of noninvasive positive-pressure ventilation (NPPV) in treating patients with severe respiratory failure (RF) caused by chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>Patients in the control group (n=23) were treated with conventional therapy plus NPPV, and those in the treatment group (n=25) received the same treatment but with intravenous infusion of SMI 30 ml once a day additionally. The treatment lasted for 10 days. Arterial oxygen saturation (SaO2) was continuously monitored in all patients, arterial blood gas values was determined before treatment and at the 6th hour, the 24th hour, the 3rd day and the 7th day after treatment, and consciousness, breath, heart rate and severity of dyspnea were observed during the treating period.</p><p><b>RESULTS</b>All patients in the treatment group were markedly improved and discharged from hospital, while in the control group 20 were improved and discharged from hospital, but the other 3 failed to be remitted and received the conventional invasive mechanical ventilation. The duration of hospitalization and ventilation were 11.3 +/- 2.5 d and 5.8 +/- 2.8 d in the treatment group, and 13.2 +/- 2.7 d and 7.5 +/- 3.0 d in the control group, showing significant difference in the two indexes between the two groups (P < 0.05). The dyspnea score and the arterial blood gas values determined on the 3rd and 7th day were significantly improved in the treatment group than those in the control group (P < 0.05 or P < 0.01). The incidence of endotracheal intubation caused adverse reaction, such as facial-skin crush wound, abdominal distention and contaminated infection in the treatment group was obviously lessened as compared with the control group.</p><p><b>CONCLUSION</b>SMI could shorten the duration of hospitalization and mechanical ventilation, reduce trachea cannulation, and decrease the incidence of complications and adverse reactions in the patients with severe RF due to COPD treated with NPPV.</p>
