A Modular Approach for a Patient Unit for Extracorporeal Membrane Oxygenation Simulator

Abstract

Despite many advancements in extracorporeal membrane oxygenation (ECMO), the procedure is still correlated with a high risk of patient complications. Simulation-based training provides the opportunity for ECMO staff to practice on real-life scenarios without exposing ECMO patients to medical errors while practicing. At Hamad Medical Corporation (HMC) in Qatar, there is a critical need of expert ECMO staff. Thus, a modular ECMO simulator is being developed to enhance the training process in a cost-effective manner. This ECMO simulator gives the instructor the ability to control the simulation modules and run common simulation scenarios through a tablet application. The core modules of the simulation system are placed in the patient unit. The unit is designed modularly such that more modules can be added throughout the simulation sessions to increase the realism of the simulation sessions. The new approach is to enclose the patient unit in a trolley, which is custom-designed and made to include all the components in a modular fashion. Each module is enclosed in a separate box and then mounted to the main blood simulation loop box using screws, quick connect/disconnect liquid fittings, and electrical plugs. This method allows fast upgrade and maintenance for each module separately as well as upgrading modules easily without modifying the trolley’s design. The prototype patient unit has been developed for portability, maintenance, and extensibility. After implementation and testing, the prototype has proven to successfully simulate the main visual and audio cues of the real emergency scenarios, while keeping costs to a minimum.

Virtual and Artificial Cardiorespiratory Patients in Medicine and Biomedical Engineering

“…ECMO is a medical technology that has two applications: for cardiovascular support (by venous-arterial (V-A) cannulation) and for treatment of acute respiratory failure (by veno-venous (V-V) cannulation). An enormous increase of ECMO centers in recent years was observed [42] and in order to increase patients' safety and to optimize ECMO efficacy, both training simulators as well as hybrid simulators are needed [43][44][45][46][47][48]. The simulators can help in ECMO system training, enabling, in some cases, high fidelity clinical scenarios [43,44] or to study the hemodynamic effect of ECMO on the left ventricular loading in a V-A configuration and the parasitic effect of blood recirculation in V-V cannulation [46].…”

“…An enormous increase of ECMO centers in recent years was observed [42] and in order to increase patients' safety and to optimize ECMO efficacy, both training simulators as well as hybrid simulators are needed [43][44][45][46][47][48]. The simulators can help in ECMO system training, enabling, in some cases, high fidelity clinical scenarios [43,44] or to study the hemodynamic effect of ECMO on the left ventricular loading in a V-A configuration and the parasitic effect of blood recirculation in V-V cannulation [46]. However, these simulators usually can only mimic the hemodynamic physical effect when connected to an actual ECMO.…”

A Review of Human Circulatory System Simulation: Bridging the Gap between Engineering and Medicine

“…In this case study, the focus is on the cannulation simulator and its implementation. More details about the ECMO machine simulator can be found in [38,39].…”

Simulators and Simulations for Extracorporeal Membrane Oxygenation: An ECMO Scoping Review

“…Currently, only SBT programs have been reviewed and compared, but not ECMO sims themselves. Some developers, such as Alhomsi, et al [13], tried to compare their work to different ECMO sims but lacked guidelines for comparison, making them subjective. Therefore, this study presents a structured and objective way of classifying available ECMO sims.…”