ICU as the medical trump card and its following-up parameters (救命への切り札としての ICUと、その医療的モニター項目) Kazuhide Okada, Ph.D. Professor Medical Engineering Dept., Medical Faculty, New Tokyo Medical College, Pohnpei Campus 岡田 一秀 教授 　　　新東京医科大学ポンペイ校医学部 　　　医用工学教室

Outward Appearance of ICU (Intensive Care Unit) * Many sharing rooms in JP * Many private rooms in US

Blood Vessel sequence and Blood Pressure Right atrium T

The objective of ICU　 Watching a patient for 24 hours (especially for life-saving from hepatocirrhosis, cerebral infarction, and respiratory failure - No. of heartbeat - Blood Pressure of the artery - Blood Pressure of the pulmonary artery (30～15 to 8～2mmHg) * To check Pulmonary Artery Hypertension (difficulty in breathing, chest pain, palpitations) - Central venous pressure - Blood pressure of Arterioles - SpO2 (Saturation measurement of Percutaneous Oxygen - measured by Pulse Oximeter) ※　In case of the serious cardiac disease, 　　 CCU (Coronary Care Unit) is used.

Time Course of Pulmonary Artery Hypertension

What is Pulse Oximeter ? There is the red LED inside the pulse oximeter. By irradiating its light on the nail, The amount of oxygen in the finger artery is measured on real-time processing. Its figure is just like the clothespin. nail nail ※ Anemia checking can be done for the patient by this apparatus.

Structure of Hemoglobin (One of protein) Hemoglobin (Model) Hemoglobin (Actual)

Degree of absorption of the rays on Hb and HbO2

The Relationship between the electromagnetic wave category and it wavelength ※　The transmission speed of these signals are all 3*108m/s

Ray-absorption accompanied with multiple scattering Input I (Intensity of the ray passing the dispersed molecules) From the Beer-Lambert’s expression inside the finger, Adopted for the ray whose frequency is around near infrared ray I = ηIo exp [( -αVo - βVd)L’ - μs L] Io: Intensity of the irradiated ray, η: Coefficient related with the optical system, Vo: Amount of oxidized Hemoglobin/tissue volume, Vd: Amount of non-oxidized Hemoglobin/tissue volume, α: The absorption coefficient of oxidized Hemoglobin, β: The absorption coefficient of non-oxidized Hemoglobin, L:Distance between the irradiation point and the receiver point, L’ :Light Path length (The distance along which the ray has really passed ), μs: Dispersion Coefficient of Tissue By changing wavelength of the said ray, we can get Vo and Vd as the constants. Solve Simultaneous Linear Equations

How to get Saturation measurement of Percutaneous Oxygen SpO2 = Vo/(Vo+Vd) Vo: Amount of oxidized Hemoglobin /tissue volume, Vd: Amount of non-oxidized Hemoglobin /tissue volume Standard of SpO2: (Higher, Better) - 99% through 96% for Healthy bodies - Less than 90% for Patients of (acute/chronic) respiratory failure Proofreading is needed

Block Diagram of Pulse Oximeter Pulse Duty Control IR Sensing After getting V0 and Vd from Beer-Lambert’s formula, SpO2 is calculated, quoting from the proofreading profile R Sensing Electrical Macro- Path of P.O. Heart beat Sensing 12V for Analog parts and 3.3V for Digital parts

Challenging Items for ICU in future There are still a few life-saving specialist in the emergency The care for the patient with the brain death Enhancement of the ratio of respirator-removal (winning)

Guidance (ご紹介) - To Extend the human lives worldwide - (世界市民みんなが、少しでも寿命を延ばせるように） http://twitcasting.tv/kehua_and_kazu http://twitcasting.tv/kehua_and_kazu/show/ KEHUA : Kind (Knowable) Engineering for Health for Uｓ with Advancement 　 （先進性を考慮した、我々に優しい (易しい)、 医工学） [Kolonia, Pohnpei, FSM] Every Weekend On air changing the category of disease or the medical machine About the Bio-Medical Engineering. On the 1st week and the 3rd week in Japanese. And on the 2nd and 4th week in English. From 8PM on Friday or from 11AM on Saturday in FSM time. - Kazu. Okada From Kolonia, Daini Studio 私の仕事の都合にも依りますが、毎週、日本時間では、金曜の午後６時頃か、土曜の午前９時頃に、病種や、 医療機械種を変えながら、上記サイトにて、医工学ツイキャスを、コロニア・第二スタジオより、放送しております。 毎月第１週と第３週は、日本語で、第２週と第４週は、英語で発信しております。特に、原稿もなく、「これこれは、 健康や技術展開言う場合、重要かなあ。」と言う感じで、いきなり話をしているのですが、よろしく、お願いします。　　　　 岡田一秀