In today's healthcare environment there is an increasing move towards mobile technology to meet clinical needs. Wireless communication is key to allowing medical devices to be able to move with the patient, while continuing to record and communicate patient data. Each application has demands on the connectivity infrastructure such as availability, reliability, and data payload capability. Furthermore, wireless medical device applications may share RF spectrum resources with a host of other non medical device applications.Although hospitals traditionally segregate data network traffic and patient care data network traffic, the increased costs for a hospital to utilize two separate network infrastructures has led some to consider whether or not wireless medical devices should be integrated onto IT-type 802.11 wireless networks.While there are arguable advantages to incorporating all devices onto a single network infrastructure, there are increased potential patient safety risks that must be addressed.In order to address the increased risks of incorporating wireless medical devices on hospital's 802.11 wireless networks, thorough evaluation and testing is essential. While it is unreasonable due to cost and resources to design an ideal test lab, there are pragmatic designs that can be implemented to create a functioning test lab for wireless medical devices.
Background: An impedance threshold device (ITD) has been designed to enhance circulation during CPR. A recent study suggests that the ITD does not improve hemodynamics and that it may worsen outcomes. We sought to determine, in a blinded fashion, the effect of the ITD on coronary perfusion pressure (CPP), passive ventilation (paO2 & paCO2), and return of spontaneous circulation (ROSC), in a porcine model of prolonged ventricular fibrillation (VF). We hypothesized that, when compared to sham, the active device would have no significant impact on these variables.
Methods: Thirty devices (15 active/15 sham) were purchased from the Resuscitation Outcomes Consortium. Thirty male Yorkshire swine were instrumented under anesthesia. VF was electrically induced. After 8” of untreated VF, baseline characteristics were documented and CPR was begun (chest compressions rate 100/minute and ventilations at a ratio of 30:2). The device used on a given animal (active or sham) was randomly assigned. After 3 cycles of basic CPR, a second ABG was drawn and a drug cocktail was given followed by 6 CPR cycles. We recorded CPP continuously. The first 150J rescue shock (RS) was delivered after 9 complete cycles (3 minutes) of CPR. A third ABG was drawn just prior to the first RS. ROSC was defined as systolic blood pressure >80 mmHg for >60s continuously. The randomization code was revealed once preliminary data analysis was completed. Group comparisons were assessed using descriptive statistics, Student’s
t
-test for continuous variables and Fisher’s Exact Test for dichotomous variables. Proportions with 95% confidence intervals were calculated for the rate of ROSC.
Results: Baseline characteristics between the two groups were the same. ROSC occurred in 14/15 animals in both active and sham. The table
summarizes the results (mean) by group after each event/intervention (CPP in mmHg, paO2 & paCO2 in torr).
Conclusions: Use of the active device had no impact on CPP, paO2 & paCO2 or ROSC compared to sham.
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